磁共振DWI、IVIM与宫颈癌病理学特征的相关性研究

目的评价对比体素内不相干运动(intravoxel incoherent motion,IVIM)与磁共振扩散加权成像(diffusion weighted imaging,DWI)在鉴别宫颈鳞癌与正常宫颈组织及宫颈鳞癌分化程度中的价值。材料与方法将46例待检查者(包括9名正常人和37例病理证实的宫颈癌鳞癌患者)进行盆腔MRI常规及IVIM序列扫描,根据宫颈癌病理分化程度不同,将宫颈癌患者分为低、中、高分化3组(分别为8人、20人、9人),在磁共振检查前每例患者均未采取过任何治疗措施。结果 (1)相较于正常宫颈组织,宫颈鳞癌的D值、表观扩散系数(apparent diffusion coefficient,ADC)值降低而D~*值、f值升高,且各参数的变化差异均具有统计学意义(P0.05);ADC值具有最佳诊断效能。(2)宫颈鳞癌分化程度越低,D值、ADC值越小,D~*值、f值越大。不同分化程度宫颈癌两两对比,ADC值、D值差异均有统计学意义(P0.001),鉴别中、高分化宫颈鳞癌时,ADC值具有最佳诊断效能,鉴别低、中分化时,D值均具有最佳诊断效能;f值在鉴别高分化、低分化宫颈鳞癌中差异有统计学意义(P0.05);D~*值差异没有统计学意义(P0.05)。结论 IVIM与DWI能够鉴别宫颈癌与正常宫颈组织,IVIM在鉴别不同分化程度宫颈鳞癌中有重要意义。

Study of the correlation between DWI and IVIM and the pathology of cervical cancer

Objective: To evaluate and contrast intravoxel incoherent motion (IVIM) and diffusion-weighted imaging (DWI) in the differentiation of cervical squamous cell carcinima and normal cervical tissue and cervical squamous cell carcinima. Materials and Methods: Collecting 9 normal people and 37 patients diagnosed with cervical squamous cell carcinoma according to surgery or biopsy with pelvic MRI routine scan sequence and IVIM sequences. In the 37 patients, including 9 high differentiation cervical squamous cell cancer, 20 medium differentiation cervical squamous cell cancer and 8 low differentiation cervical squamous cell cancer. Everyone underwent cervical magnetic resonance imaging (MRI) examination before treatment. Results:(1) The values of ADC, D in cervical squamous cell carcinoma were lower than those in normal cervical tissue, the values of D*, f in cervical squamous cell carcinoma were higher than those in normal cervical tissue, they all had obvious differences (P<0.05), the mean value of ADC had the best diagnostic efficiency. (2) The mean values of ADC and D were smaller and D* and f were bigger in the lower differentiated squamous cell carcinoma; The mean values of D between any differentiated degree differentiation cervical squamous cell carcinoma had obvious difference (P<0.001);When differentiating high from medium differentiated squamous cell carcinoma, the mean value of ADC had the best diagnostic efficiency; When differentiating poorly from medium differentiated squamous cell carcinoma, the mean value of D had the best diagnostic efficiency; The mean values of f between high and poorly differentiation cervical squamous cell carcinoma had obvious difference (P<0.05); The mean values of D* between any differentiated degree differentiation cervical squamous cell carcinoma had no obvious difference (P>0.05). Conclusion: IVIM and DWI can differentiate cervical cancer and normal cervical tissue, it is important of IVIM in distinguishing different degree of the cervical squamous carcinoma.