IVIM-DWI、DCE-MRI参数诊断老年宫颈癌病理分型分级价值  

Values of the parameters of intravoxel incoherent motion diffusion weighted imaging and dynamic contrast-enhanced magnetic resonance imaging of elderly patients with cervical cancer for differential diagnosing their pathological classification and pathological grading

作　　者：毛晓铧 葛玉杰 徐力君 喻志斌 MAO Xiaohua;GE Yujie;XU Lijun;YU Zhibin(Fuyang District Hospital of Traditional Chinese Medicine,Hangzhou,Zhejiang Province,311400)

机构地区：[1]浙江省杭州市富阳区中医院,311400

出　　处：《中国计划生育学杂志》2023年第9期2219-2223,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨老年宫颈癌患者核磁共振检查体素内不相干运动弥散加权成像(IVIM-DWI)及动态增强磁共振成像(DCE-MRI)参数鉴别肿瘤病理分型以及鳞癌分化程度价值。方法:选取2019年1月-2022年6月本院体检发现的老年宫颈癌患者86例,采用磁共振T1WI、T2WI和IVIM-DWI和DCE-MRI序列进行检查,分别测量表观弥散系数(ADC)、慢扩散系数(D)、快扩散系数(D^(*))、灌注分数(f)、容积运转常数(K^(trans))、速率常数(K_(ep))和容积分数(Ve)等参数,受试者工作特征曲线(ROC)分析各参数鉴别诊断宫颈癌病理分型和分级价值。结果:患者鳞癌ADC和D低于非鳞癌,D^(*)、f、K^(trans)和K_(ep)高于非鳞癌,低分化鳞癌ADC和D低于中高分化鳞癌,D^(*)、K^(trans)、K_(ep)和Ve高于中高分化鳞癌(P<0.05);ADC、D、D^(*)、f、K^(trans)和K_(ep)鉴别诊断老年宫颈鳞癌的ROC曲线下面积(AUC)分别为0.688、0.856、0.770、0.592、0.771和0.805,各参数联合诊断的AUC为0.948,敏感度95.5%,特异度94.4%;ADC、D、D^(*)、K^(trans)、K_(ep)和Ve鉴别诊断老年宫颈鳞癌中低分化癌的AUC分别为0.696、0.716、0.586、0.642、0.704和0.746,各参数联合诊断AUC为0.900,敏感度97.6%/特异度75.0%。结论:老年宫颈癌不同病理分级和鳞癌分化程度患者IVIM-DWI和DCE-MRI参数均存在差异,各参数联合检测可为鉴别宫颈癌病理性质提供参考信息。Objective:To study the values of the parameters of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)of elderly patients with cervical cancer for differential diagnosing their pathological classification and pathological grading.Methods:86elderly patients with cervical cancer found during the physical examination from January 2019to June 2022were selected in this study.The magnetic resonance imaging T1WI,T2WI,IVIM-DWI,and DCE-MRI sequences were used for measuring the values of the parameters of the patients,such as apparent diffusion coefficient(ADC),slow diffusion coefficient(D),fast diffusion coefficient(D^(*)),and perfusion fraction(f),volume transfer constant(K^(trans)),rate constant(K_(ep)),and volume fraction(Ve).Receiver operating characteristic(ROC)curve was used to analyze the values of these parameters of the patients for differential diagnosing their pathological classification and pathological grading of the cervical cancer.Results:The values of ADC and D of the elderly patients with squamous cell carcinoma were significantly lower than those of the elderly patients with non-squamous cell carcinoma,while the values of D^(*),f,K^(trans),and K_(ep) of the elderly patients squamous with squamous cell carcinoma were significantly higher(P<0.05).The values of ADC and D of the elderly patients with poorly differentiated squamous cell carcinoma were significantly lower than those of the patients with moderately and well-differentiated squamous cell carcinoma,while the values of D^(*),K^(trans),and K_(ep) of the patients with poorly differentiated squamous cell carcinoma were significantly higher(P<0.05).The area under the curve(AUC)of the values of ADC,D,D^(*),f,K^(trans),and K_(ep) of the elderly patients for differential diagnosing their cervical squamous cell carcinoma were 0.688,0.856,0.770,0.592,0.771,and 0.805,respectively.The AUC,the sensitivity,and the specificity of the combined values of ADC,D,D^(*),f,K^(trans),and K_(e

关 键 词：老年宫颈癌 病理分型 病理分级 核磁共振检查 体素内不相干运动扩散加权成像 动态增强磁共振成像 鉴别诊断 

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]