高清与传统扩散加权成像在评价宫颈癌盆腔淋巴结转移中的对比研究  

A comparative study of high definition and conventional diffusion weighted imaging in evaluating pelvic lymph node metastasis of cervical cancer

作　　者：唐双 黄泽涵 孟铁豹 张蔚菁 何浩强[1] 谢传淼[1] TANG Shuang;HUANG Ze-han;MENG Tie-bao(Department of Medical Imaging,Sun Yat-Sen University Cancer Center,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心影像科,广州510060 [2]中山大学孙逸仙纪念医院深汕中心医院放射科,广东汕尾516621

出　　处：《放射学实践》2024年第7期919-923,共5页Radiologic Practice

摘　　要：目的:基于复合灵敏度编码的高清扩散加权成像(MUSE DWI)与传统DWI在评价宫颈癌盆腔淋巴结转移中的对比研究。方法:收集行手术治疗的54例宫颈癌患者的病例资料,所有患者术前行磁共振检查,包含传统DWI序列和MUSE DWI序列。分析比较两组DWI序列在宫颈癌盆腔淋巴结中的整体图像质量、矫正几何失真程度和病变显示程度及信噪比(SNR)、对比噪声比(CNR)和平均表观扩散系数(ADC)。采用独立样本t检验分析两组ADC值在盆腔转移性淋巴结和非转移性淋巴结之间的差异,并用受试者操作特征(ROC)曲线评价两组ADC值鉴别宫颈癌盆腔淋巴结转移的诊断效能,采用Delong检验比较两种序列诊断效能的差异。结果:MUSE DWI的整体图像质量、矫正几何失真程度、病变显示程度、SNR和CNR均显著高于传统DWI(P均<0.001)。MUSE DWI和传统DWI的ADC值差异有统计学意义(P<0.001)。在MUSE DWI和传统DWI中,转移组的ADC值均显著低于非转移组(P<0.001)。MUSE DWI和传统DWI的鉴别诊断宫颈癌盆腔淋巴结转移能力的ROC曲线下面积分别为0.718和0.646,两种序列间差异没有统计学意义(P=0.094)。结论:MUSE DWI序列的图像质量、SNR和CNR均优于传统DWI,ADC值差异有统计学意义。MUSE DWI和传统DWI都可以鉴别宫颈癌盆腔淋巴结转移,两者的诊断效能无显著差异。Objective:To compare the effectiveness of multiplexed sensitivity encoding diffusion weighted imaging(MUSE DWI) and conventional DWI in the evaluation of pelvic lymph node metastasis in cervical cancer patients.Methods:A total of 54 patients who underwent surgical treatment for cervical cancer were included in the study.MRIs were performed before surgery,including conventional DWI and MUSE DWI sequences.The overall image quality,correct geometric distortion degree,lesion display degree,signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and apparent diffusion coefficient(ADC) of the two sequences were analyzed and compared.The independent sample T-test was used to analyze the difference in ADC values obtained by these two sequences between pelvic metastatic and non-metastatic lymph nodes.The receiver operating characteristic curve(ROC) was used to evaluate the diagnostic efficacy,and the Delong test was used to compare the differences in the ROCs.Results:The overall image quality,correct geometric distortion degree,lesion display degree,SNR and CNR of MUSE DWI were significantly higher than those of conventional DWI(P<0.001).The ADC values of MUSE DWI and conventional DWI were significantly different(P<0.001).In MUSE DWI and conventional DWI,ADC values in the metastatic group were significantly lower than those in the non-metastatic group(P<0.001).The area under ROC curve for the differential diagnosis of cervical cancer pelvic lymph node metastasis in MUSE DWI and conventional DWI was 0.718 and 0.646,respectively,with no statistically significant difference between the two ROCs(P=0.094).Conclusion:Athough MUSE DWI displayed better image quality,SNR,and CNR than conventional DWI,both MUSE DWI and conventional DWI can distinguish pelvic lymph node metastasis in cervical cancer patients effectively,with no significant difference in diagnostic efficiency.

关 键 词：磁共振成像 扩散加权成像 高清扩散加权成像 宫颈癌 淋巴结转移 

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]