MRI平扫联合DWI对宫颈癌术前病理分期及宫旁浸润的评估价值分析  

Analysis of the Value of MRI Plain Scan Combined with DWI in the Evaluation of Preoperative Pathological Staging and Parametrial Invasion of Cervical Cancer

作　　者：林娟 陈文春 姜剑榕 陈起强 陈铃雄 LIN Juan;CHEN Wenchun;JIANG Jianrong(Department of Radiology,Mindong Hospital Affiliated to Fujian Medical University,Ningde,Fujian Province 355000 P.R China)

机构地区：[1]福建医科大学附属闽东医院放射影像科,宁德355000

出　　处：《临床放射学杂志》2025年第5期914-918,共5页Journal of Clinical Radiology

摘　　要：目的探究MRI平扫联合扩散加权成像(DWI)对宫颈癌术前病理分期及宫旁浸润的评估价值。方法回顾性选取2021年8月至2024年4月本院收治的77例宫颈癌患者为研究对象,所有患者均行MRI平扫和DWI检查,根据不同扫描序列获得的图像对患者病理分期和宫旁浸润进行评估,并行定量指标测量。比较MRI平扫和DWI检查对患者病理分期和宫旁浸润的诊断情况,并采用受试者工作特征(ROC)曲线分析其对宫旁浸润的评估价值。结果平扫联合DWI对病理分期诊断的准确率(94.81%)高于MRI平扫的准确率(80.52%)(P<0.05)。针对Ⅱ期患者,平扫联合DWI诊断的准确率为94.74%,高于平扫的准确率78.95%(P<0.05)。表观扩散系数(ADC)值随着分期的上升而下降,不同分期的宫颈癌患者ADC之间差异有统计学意义(P<0.05)。MRI平扫对宫颈癌宫旁浸润评估的准确率(64.94%)低于平扫联合DWI的准确率(87.01%)(P<0.05)。宫旁浸润阳性患者的ADC值低于阴性患者(P<0.05)。ADC值、平扫和平扫联合DWI对宫旁浸润均有一定的评估价值,其AUC分别为0.718、0.641和0.880,其中MRI平扫联合DWI的评估效能最高,其灵敏度和特异度分别为93.75%和82.22%。结论MRI平扫联合DWI能提高对宫颈癌患者术前病理分期的诊断准确率,且联合检查能提升对宫颈癌宫旁浸润的评估效能,值得临床推广。Objective To explore the evaluation value of magnetic resonance imaging(MRI)plain scan combined with diffusion-weighted imaging(DWI)in the preoperative pathological staging and parametrial invasion of cervical cancer.Methods A total of 77 cases of cervical cancer treated in our hospital from August 2021 to April 2024 were retrospectively selected as the research subjects.All patients underwent MRI plain scan and DWI examination.The pathological staging and parametrial invasion of cervical cancer were assessed based on the images obtained from different scan sequences,and quantitative indicators were measured.The diagnostic performance of MRI plain scan and DWI examination on pathological staging and parametrial invasion was compared,and the receiver operating characteristic(ROC)curve was used to analyze their evaluation value for parametrial invasion.Results The accuracy of pathological staging diagnosis by plain scan combined with DWI was 94.81%,which was higher than that of MRI plain scan alone(80.52%,P<0.05).For stageⅡpatients,the diagnostic accuracy of plain scan combined with DWI was 94.74%,which was higher than that of plain scan alone(78.95%,P<0.05).The ADC value decreased with increasing stage,and the differences in ADC values between cervical cancer patients with different stages were statistically significant(P<0.05).The accuracy of MRI plain scan in assessing parametrial invasion of cervical cancer was 64.94%,which was lower than that of plain scan combined with DWI(87.01%,P<0.05).The ADC value of patients with positive parametrial infiltration was lower than that of patients with negative infiltration(P<0.05).The ADC value,MRI plain scan,and MRI plain scan combined with DWI all have certain evaluation value for parametrial invasion,with AUC values of 0.718,0.641,and 0.880,respectively.Among them,MRI plain scan combined with DWI had the highest evaluation efficiency,with a sensitivity of 93.75%and specificity of 82.22%.Conclusion MRI plain scan combined with DWI can improve the diagnostic accuracy of

关 键 词：磁共振成像 弥散加权成像 宫旁浸润 病理分期 表观扩散系数 

分 类 号：R737.33[医药卫生—肿瘤]