磁共振弥散加权成像对宫颈癌复发的诊断价值

目的探讨磁共振弥散加权成像对宫颈癌复发的诊断价值。方法收集宫颈癌术后在我院复查MRI检查患者121例，其中行放疗37例，以手术或穿刺病理证实复发32例，先分为复发组与未复发组，再按术后是否行放射治疗分为单纯术后组及手术加放疗组，复发组分为单纯术后复发组及手术后加放疗后复发组，分别测量术后、放疗后宫颈残端与复发肿瘤的ADC值，进行对比分析；采用DWI诊断宫颈癌复发与病理进行对照比较，以敏感性、特异性及准确率三项指标分析DWI对其复发的诊断价值。结果术后、术后放疗后与复发癌灶ADC值两两对比，差异有显著性意义，术后复发与术后放疗后复发无统计学意义；DWI成像对宫颈癌复发的敏感性、特异性及准确率分别为：100％、95．51％、96．69％。结论弥散加权成像可以作为评估宫颈癌复发的准确检查方法。

The diagnostic value of magnetic resonance diffusion-weighted imaging in cervical cancer recurrence

Objective To evaluate the diagnostic value of magnetic resonance diffusion-weighted imaging in cervical canc er recurrence. Methods 121 postoperative cervical cancer patients, who were made MRI examination in our hospital, were collected in this work. Among these patients, 37 were treated by radiotherapy and 32 expericenced recurrence as confirmed by surgery or biopsy. These patients were divided into two groups, i. e. , recurrent group and no recurrent group. The no recurrent group was further divided into pure operation group and postoperative radiotherapy group. The ADC values of the three groups were measured and analyzed and combined with the result of biopsy. The sensitivity, specificity and accu racy were used to analyze the diagnostic value of DWI in recurrence cervical cancer. Results The recurrence rate of cervi cal cancer was 78.13% in 2 years. The ADC value of surgery, radiotherapy and recurrent group showed statistical signifi cance between the two group （T value 3.56, 10.97, 5.84, P d0.01）. The sensitivity, specificity and accuracy of DWI imaging in cervical cancer were 100%, 95. 69%, 96. 69 %, respectively. Conclusion Diffusion-weighted imaging can be considered as an accurate assessment for screening the recurrence of cervical cancer.