探讨T_(2)WI、DWI和T_(2)-DWI融合序列在子宫颈癌宫旁侵犯的诊断价值  

The Diagnostic Value of the T_(2)WI,DWI,and T_(2)-DWI Fusion Images for Parametrial Invasion of Cervical Cancer

作　　者：莫少芬 黄建锋[1] 江楚君 邹玉坚[1] 林志萍 李俭 李兰 李建鹏[1] MO Shao-fen;HUANG Jian-feng;JIANG Chu-jun;ZOU Yu-jian;LIN ZHI-ping;LI Jian;LI Lan;Li JIAN-peng(Department of Radiology,The Tenth Affiliated Hospital of Southern Medical University(Dongguan People's Hospital),Dongguan 523000,Guangdong Province,China;Community Health Services Center Of Dongguan Guancheng,Dongguan 523000,Guangdong Province,China;Department of Gynaecology,The Tenth Affiliated Hospital of Southern Medical University(Dongguan People's Hospital)Dongguan 523000,Guangdong Province,China;GE Healthcare,Guangzhou 510623,Guangdong Province,China)

机构地区：[1]南方医科大学第十附属医院(东莞市人民医院)放射科,广东东莞523000 [2]东莞市莞城社区卫生服务中心,广东东莞523000 [3]南方医科大学第十附属医院(东莞市人民医院)妇科,广东东莞523000 [4]通用电气药业(上海)有限公司,广东广州510623

出　　处：《中国CT和MRI杂志》2023年第9期147-150,共4页Chinese Journal of CT and MRI

基　　金：广东省东莞市社会科技发展面上项目(20221800901542)。

摘　　要：目的评估T_(2)WI、T_(2)WI+DWI和T_(2)-DWI融合序列对子宫颈癌宫旁侵犯的诊断价值。方法回顾性收集我院105例宫颈癌患者临床和MRI资料。MRI检查包括T_(2)WI、DWI和T_(2)-DWI融合序列。由一名妇科医师、一名低年资放射医师和一名高年资放射医师采用半定性六分置信度表对上述图像分别进行诊断。统计学分析包括三位医师诊断结果的一致性检验、计算受试者工作特征曲线(ROC)下面积(AUC)等比较。结果三位医师用T_(2)-DWI融合序列的评分结果的一致性最高。对于T_(2)WI、T_(2)WI+DWI和T_(2)-DWI融合序列诊断子宫颈癌宫旁浸润,妇产科医师的AUC分别为:0.793、0.887和0.906;低年资放射医师的AUC为:0.911、0.914和0.978;高年资放射医师的AUC为:0.965、0.977和0.972。通过Delong检验,妇科医师和低年资放射医师用T_(2)-DWI融合序列的诊断效能高于用T_(2)WI序列,两位放射医师用T_(2)-DWI融合序列的诊断效能无统计学差别。结论T_(2)-DWI融合序列图像直观,在子宫颈癌宫旁侵犯具有良好的诊断价值,可为术前准确分期提供可靠的帮助。Objective To evaluate the diagnostic value of sequences of T_(2)-weighted imaging(T_(2)WI),T_(2)WI plus diffusion-weighted imaging(DWI),and T_(2)-DWI fusion images for parametrial invasion of cervical cancer.MethodsIn the retrospective study,the clinical and MRI data of 105 patients with cervical cancer were collected.MRI examination included T_(2)WI,DWI,and T_(2)-DWI fusion images,which were analyzed by a gynecologist,a junior radiologist and a senior radiologist with a confidence level calculated using a six-point confidence scale.The diagnostic results obtained were statistically analyzed using consistency test of the three physicians,receiver operating characteristic(ROC)curve and area under curve(AUC).ResultsThe T_(2)-DWI fusion images achieved the highest consistency of the scores calculated among the three physicians.For assessing parametrial invasion of cervical cancer,T_(2)WI,T_(2)WI plus DWI,and T_(2)-DWI fusion images yielded AUCs of 0.793,0.887,0.906 in the gynecologist,0.911,0.914,and 0.978 in the junior radiologist,and 0.965,0.977 and 0.972 in the senior radiologist,respectively.According to Delong test,the diagnostic efficiency of T_(2)-DWI fusion images outperformed the T_(2)WI in both gynecologist and junior radiologist,while no significant difference was found in T_(2)-DWI fusion images between the two physicians.ConclusionT_(2)-DWI fusion images are intuitive and show good diagnostic value in parametrial invasion of cervical cancer,which can provide reliable assistance for accurate preoperative staging.

关 键 词：子宫颈癌 核磁共振成像 宫旁浸润 术前诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]