简体中文

论著-头颈部

MRI联合DWI在宫颈癌诊断中的价值

作者:崔麦玲 卢淑丽

所属单位:河南省安阳市妇幼保健院妇科(河南 安阳 455000)

PDF

摘要

目的 探讨磁共振成像(MRI)联 合弥散加权成像(DWI)在宫颈癌诊断中 的价值。方法 选取2015年1月至2017年 10月在我院治疗的宫颈癌患者63例,所 有患者均行常规MRI和DWI扫描。结果 宫 颈癌MRI分期、MRI+DWI与病理分期Kappa 值分别为0.507和0.794,P<0.05;宫颈 癌MRI+DWI分期总体准确率为84.13%,明 显高于MRI分期(P<0.05);宫颈鳞癌和 腺癌组织表观扩散系数(ADC)值比较差异 无统计学意义(P<0.05);放化疗后病 灶ADC值为(1.50±0.21)×10-3mm2 /s,明 显高于放化疗前(P<0.05);完全缓解 (CR)患者病灶ADC值为(1.52±0.12)×10- 3 mm2 /s,明显高于部分缓解(PR)患者(P <0.05)。结论 MRI联合DWI在宫颈癌诊 断中有较好的价值,在宫颈癌分期诊断 中有较高的准确性,且DWI定量指标ADC 在放化疗效果评价中有一定作用。

Objective To explore the value of magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) in the diagnosis of cervical cancer. Methods 63 cases of cervical cancer treated in our hospital from January 2015 to October 2017 were selected, the routine MRI and DWI scan were performed in all patients. Results The MRI staging, MRI+DWI and pathological staging of cervical cancer were 0.507 and 0.794, P<0.05. The overall accuracy rate of MRI+DWI staging for cervical cancer was 84.13%, which was significantly higher than that in MRI staging (P<0.05). There was no significant difference in the apparent diffusion coefficient (ADC) between the squamous cell carcinoma and the adenocarcinoma of the cervix (P<0.05). The ADC value of the lesion after radiotherapy and chemotherapy was (1.50±0.21)×10-3mm2 /s, which was significantly higher than that before radiotherapy and chemotherapy (P<0.05). The ADC value of the patients with complete remission (CR) was (1.52±0.12)×10- 3 mm2 /s, significantly higher than that of patients with partial remission (PR) (P<0.05). Conclusion MRI combined with DWI has a good value in the diagnosis of cervical cancer, has high accuracy in cervical cancer staging diagnosis, and DWI quantitative index ADC plays a certain role in evaluating the effect of radiotherapy and chemotherapy.

【关键词】磁共振成像;弥散加权成像; 表观扩散系数;宫颈癌

【中图分类号】R711.74

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.06.032

前言

宫颈癌发病原因目前尚不明晰,早婚、早育、多产及性生活紊乱 均是发病的重要因素,是女性常见恶性肿瘤之一,并具有明显的年轻 化趋势[1]。早期宫颈癌并无明显的临床症状,被发现患者多为晚期, 故此,宫颈癌的早期准确诊断对预后和治疗意义重大。磁共振成像 (magnetic resonance imaging,MRI)是现阶段临床颈癌的主要影像学 方法之一,其具有多平面及、多参数成像,较高的软组织分辨力等优 势,对后期宫颈癌治疗方案的制定及监测预后等方面均具有重要意 义[12]。弥散加权成像(diffusion-weightedimaging,DWI)可对活体组 织中与水分子弥散运动有关的病变进行准确检测,属于功能成像的重 要组成部分,病变部位、浸润深度和范围均能清晰显示[2]。故此,本 研究尝试MRI联合DWI诊断宫颈癌并分析其临床价值,现作如下报道。