IVIM定量参数及联合参数在宫颈癌诊断及临床分期中的应用价值  

The value of intravoxel incoherent motion parameters and combined parameters in the diagnosis and clinical staging of cervical cancer

作　　者：冯福婷 雷智鑫 王伟[1] 陈梅泞 罗敏[1] FENG Futing;LEI Zhixin;WANG Wei;CHEN Meining;LUO Min(Zigong Fourth People's Hospital,Zigong 643000,China;Department of MR Scientific Marketing,Siemens Healthineers,Shanghai 200124,China)

机构地区：[1]自贡市第四人民医院放射科,自贡643000 [2]西门子医疗系统有限公司磁共振科研部,上海200124

出　　处：《磁共振成像》2023年第4期107-111,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：自贡市科技局重点研发项目(编号:2019YLSF27)。

摘　　要：目的 探讨体素内不相干运动(intravoxel incoherent motion, IVIM)扩散加权成像定量参数及联合参数在治疗前诊断宫颈癌以及评估宫颈癌不同临床分期的价值。材料与方法 回顾性分析36例病理确诊的宫颈鳞癌患者病例及18例健康受试者资料,所有受试者均扫描MRI IVIM序列并获得以下参数:纯扩散系数(pure apparent diffusion coefficient, D)、伪扩散系数(pseudo-apparent diffusion coefficient, D*)、灌注分数(perfusion fraction, f)。所有患者根据国际妇产科医学联合会(Federation of International of Gynecologists and Obstetricians, FIGO)分期分为Ⅰ~Ⅳ期;<ⅡB期为早期宫颈癌,≥ⅡB期为中晚期宫颈癌。所有数据分析应用统计学软件SPSS 17.0进行。结果 D、D*、f值在宫颈癌组中要显著低于正常宫颈组(P<0.001);f值在Ⅰ、Ⅱ期与Ⅲ、Ⅳ期宫颈癌之间,以及早期(<ⅡB)与中晚期(≥ⅡB)宫颈癌之间差异有统计学意义(P<0.05)。联合参数D+f、D+f+D*对宫颈癌的识别效能最佳,曲线下面积(area under the curve, AUC)均为0.992;D、D+D*、D+f对早期宫颈癌识别效能最佳,AUC均为0.988。结论 IVIM定量参数可在治疗前鉴别宫颈癌和正常宫颈,有较好的诊断效能,联合各参数共同识别宫颈癌、早期宫颈癌诊断效能更佳;f值在宫颈癌的分期中有一定的价值。Objective:To investigate the value of quantitative parameters and combined parameters of intravoxel incoherent motion(IVIM)diffusion weighted imaging in the pre-treatment diagnosis of cervical cancer and the assessment of different clinical stages of cervical cancer.Materials and Methods:Thirty-six patients with cervical squamous cell carcinoma confirmed by pathology and 18 healthy subjects were collected.All subjects underwent IVIM scanning and obtained IVIM parameters:pure apparent diffusion coefficient(D),pseudo-apparent diffusion coefficient(D*)and perfusion fraction(f).All patients were classified into stagesⅠ,Ⅱ,ⅢandⅣaccording to Federation of International of Gynecologists and Obstetricians(FIGO)staging.<ⅡB stage is early cervical cancer,≥ⅡB stage is middle-advanced cervical cancer.All data analysis was performed with SPSS 17.0.Results:D,D*and f were significantly lower in the cervical cancer group than in the healthy group(P<0.001).There were significant differences in f between stages(Ⅰvs.Ⅲ/Ⅳ,Ⅱvs.Ⅲ/Ⅳ),as well as between early and middle-advanced stages cervical cancer(P<0.05).The combined parameters D+f and D+f+D*had the best efficacy in identifying cervical cancer with an area under the curve(AUC)of 0.992;D,D+D*and D+f had the best efficacy in identifying early cervical cancer with an AUC of 0.988.Conclusions:Quantitative parameters of IVIM can identify cervical cancer before treatment and have better diagnostic efficacy.It is more effective to diagnose cervical cancer or early cervical cancer using the combined parameters.The parameter f has a certain value in the staging of cervical cancer.

关 键 词：宫颈癌 磁共振成像 体素内不相干运动 临床分期 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]