DWI联合常规MRI在宫颈癌诊断分期和治疗方式选择中的应用价值

发布时间：2018-05-15 04:42

  本文选题：宫颈肿瘤 + 弥散加权成像　； 参考：《肿瘤》2015年06期

【摘要】：目的 :探讨弥散加权成像(dif usion-weighted imaging,DWI)联合常规磁共振成像(magnetic resonance imaging,MRI)检查对宫颈癌诊断分期及治疗方式选择的价值。方法 :回顾性分析42例经病理学证实的宫颈癌患者的DWI MRI资料,分析不同病理类型和病理分期宫颈癌的表观弥散系数(apparent dif usion coef cient,ADC)和指数化表观弥散系数(exponential apparent dif usion coef cient,e ADC),并与正常宫颈的ADC和e ADC以及术后病理分期结果进行比较。对放化疗组和手术组患者治疗前的ADC和e ADC进行比较。结果 :宫颈癌在DWI上呈现高信号,而正常宫颈无明显异常信号。42例宫颈癌患者宫颈癌组织的平均ADC小于18例正常宫颈组织(P=0.000);宫颈鳞癌组织的平均ADC小于腺癌组织(P=0.036);放化疗组治疗前宫颈癌组织的平均ADC明显小于手术组(P=0.000),而e ADC明显大于手术组(P=0.000)。不同病理分期宫颈癌组织的平均ADC和e ADC的差异均有统计学意义(P值均0.05)。常规MRI和DWI联合MRI对宫颈癌分期诊断的准确率分别为92.9%(39/42)和95.2%(40/42)(Kappa值分别为0.903 5和0.935 8,P0.01)。结论 :DWI联合MRI在宫颈癌的诊断分期中具有较高的应用价值,ⅡB期宫颈癌的ADC可作为治疗方式选择的参考依据。
[Abstract]:Objective: to evaluate the value of diffusion-weighted imaging (DWI) combined with conventional magnetic resonance imaging (MRI) in the diagnosis, staging and treatment of cervical cancer. Methods: the DWI MRI data of 42 patients with cervical cancer confirmed by pathology were analyzed retrospectively. The apparent diffusion coefficient (dif usion coef) and exponential apparent dif usion coef diffusion coefficient (ADCA) of cervical carcinoma with different pathological types and stages were analyzed and compared with ADC and e ADC of normal cervix and postoperative pathological staging. ADC and e ADC were compared before treatment between radiotherapy and chemotherapy group and operation group. Results: cervical cancer showed high signal intensity on DWI. There was no obvious abnormal signal in normal cervix. The average ADC of cervical cancer in 42 cases of cervical cancer was less than that of 18 cases of normal cervical tissue, the average ADC of squamous cell carcinoma of cervix was lower than that of adenocarcinoma of cervix. The average ADC of cervical carcinoma before radiotherapy and chemotherapy was lower than that of carcinoma of cervix. The mean ADC was significantly lower than that of the operation group (P < 0. 000), and the e ADC was significantly higher than that of the operation group (P < 0. 000). There were significant differences in average ADC and e ADC in cervical carcinoma with different pathological stages (P = 0.05). The accuracy of conventional MRI and DWI combined with MRI in the diagnosis of cervical carcinoma staging was 92.939 / 42) and 95.2%(40/42)(Kappa value was 0.903 5 and 0.935 8g / P 0.01, respectively. Conclusion MRI combined with DWI has a high value in the diagnosis and staging of cervical cancer. The ADC of stage 鈪，

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