多b值磁共振扩散加权成像及动态增强扫描在宫颈癌临床分期及疗效评价中的初步研究

发布时间：2018-03-17 17:07

  本文选题：宫颈癌　切入点：扩散加权成像　出处：《临床放射学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的通过分析正常宫颈及宫颈癌组织的多b值扩散加权成像(DWI)及动态增强(DCE-MRI)扫描的特点,探讨其对宫颈癌分期及监测宫颈癌放化疗疗效的价值。方法搜集经活检证实的中晚期宫颈癌患者40例(腺癌12例,鳞癌28例),进行常规MRI、多b值DWI和动态增强扫描。使用单因素方差分析法对比宫颈癌放化疗前后的多组不同b值时测得的表观扩散系数(ADC)值;采用卡方检验的Fisher确切概率法对比宫颈癌放化疗前后动态增强时间-信号强度曲线(TIC)类型,并对比宫颈癌与正常宫颈三层结构的TIC类型。结果 12例腺癌和28例鳞癌的多b值平均ADC值差异具有统计学意义(各组P0.05)。40例宫颈癌患者的TIC分布Ⅰ型2例,Ⅱ型31例,Ⅲ型7例;正常宫颈黏膜Ⅰ型33例,Ⅱ型7例;正常宫颈结合带Ⅰ型31例,Ⅱ型9例,正常宫颈肌层Ⅰ型35例,Ⅱ型5例。宫颈癌与正常宫颈组织的TIC类型分布差异具有统计学意义(χ~2=83.708,P0.05);常规MRI联合多b值DWI和动态增强扫描对宫颈癌的诊断分期与临床分期的符合率为97.5%;宫颈癌放化疗前后的ADC值差异具有统计学意义(t=30.315,P0.05);宫颈癌治疗前后的TIC分布差异有统计学意义(χ~2=52.051,P0.05)。结论多b值DWI联合动态增强检查可以提高宫颈癌的分期准确率,并对监测宫颈癌放化疗疗效有重要价值。
[Abstract]:Objective to analyze the features of DWI and DCE-MRI in normal cervix and cervical carcinoma. To evaluate its value in staging cervical cancer and monitoring the curative effect of radiotherapy and chemotherapy on cervical cancer. Methods 40 patients with advanced cervical cancer (adenocarcinoma 12 cases) confirmed by biopsy were collected. Twenty-eight patients with squamous cell carcinoma were examined with conventional MRI, multi-b DWI and dynamic contrast-enhanced scan. The apparent diffusion coefficient (ADCC) of cervical cancer before and after radiotherapy and chemotherapy was compared by univariate variance analysis. The exact probability method of Fisher based on chi-square test was used to compare the type of dynamic enhancement time-signal intensity curve before and after radiotherapy and chemotherapy for cervical cancer. Results there were significant differences in the mean ADC values of multiple b values between 12 cases of adenocarcinoma and 28 cases of squamous cell carcinoma (P0.050.40 cases of cervical cancer, 2 cases of type 鈪，

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