肝叶磁共振扩散加权成像定量评价肝硬化

【摘要】 目的 探讨不同肝叶多b值磁共振（MR）扩散加权成像（DWI）定量评价乙肝源性肝硬化的价值。方法 收集74例乙肝肝硬化患者（肝硬化组）和25名健康志愿者（对照组）,进行肝脏MR DWI成像（b=0、500、800、1000 s/mm2）。在DWI分析不同b值下肝脏各叶表观扩散系数（apparent diffusion coefficients,ADC）分别用b（0,500）、b(0,800)和b(0, 1000)表示b=500 s/mm2、800 s/mm2、1000s/mm2时的ADC值。分别统计分析b（0,500）、b(0,800)和b(0, 1000)肝左外叶、肝左内叶、肝右叶和肝尾状叶的表观扩散系数（ADC值）与肝硬化的相关性。结果 在b(0, 500)、b(0, 800)和b(0, 1000)时,在肝左外叶、肝左内叶、肝右叶和肝尾状叶测得的ADC值,除b(0, 1000)时肝左内叶ADC值与肝硬化的发生无显著相关性（r=-017,P > 005）外,其余肝叶ADC值与肝硬化的发生均呈负相关(r=-035~-060, P＜005)。在这些肝叶ADC值中,当b值为500 s/mm2时,肝左外叶测得的ADC值是区分正常肝与肝硬化的最佳指标,ROC曲线下面积（AUC）达0989。结论 肝叶磁共振扩散加权成像b值分别为500 s/mm2、800 s/mm2时,在不同肝叶测得的ADC值与肝硬化Child Pugh分级呈负相关;b(0, 500)肝左外叶ADC值是诊断肝硬化的最佳指标。     

磁共振扩散加权成像诊断前列腺癌的研究进展

目前各种影像技术成为鉴别前列腺疾病的重要方法。磁共振成像(MRI)在前列腺癌早期定性方面具有明显优势,已广泛应用于临床。MRI包括常规MRI和功能MRI,与常规MRI相比,功能MRI从单一解剖学的研究发展到与功能相结合的系统性研究,可弥补单独应用常规序列的不足。尤其是MRI扩散加权成像,不仅能反映前列腺癌组织水分子弥散特性,而且可以定量分析其内部微观结构,从而提供更全面的诊断信息。     

早期缺血性脑梗死磁共振扩散加权成像的实验研究

目的 :探讨扩散加权成像 (DWI)对早期脑梗死的诊断价值。方法 :实验组 32只经眶入路电凝法所制作的兔大脑中脉梗死模型行不同时间点 (0 .5h、1h、2h、4h、6h、8h、12h和 2 4h)DWI扫描 ,并测定表观扩散系数 (apparentdif fusioncoefficient,ADC)值。结果 :DWI上的异常高信号位于基底节、海马和顶叶皮层 ,脑梗死后 0 .5h ,ADC值开始下降 ,至 8h ,ADC值降至最低。DWI上的异常高信号区随时间推移 ,逐渐增大。结论 :DWI是诊断早期脑梗死的优选MRI序列。     

磁共振扩散加权成像、灌注加权成像在胶质瘤瘤周水肿区的应用价值

目的 探讨磁共振扩散加权成像(diffusion weighted imaging,DWI)、灌注加权成像(perfusion weighted imag-ing,PWI)在胶质瘤瘤周水肿区的应用价值.方法 选取2016年7月至2019年12月北京市房山区第一医院经手术及病理确诊的胶质瘤患者54例,其中低级别胶质瘤组23例,高级别胶质瘤组31例.术前均行常规MRI、DWI及PWI检查;将DWI、PWI原始数据经工作站软件获得表观扩散系数(relative apparent diffusion coefficient,ADC)图和脑血容量(cerebral blood volume,CBV)伪彩图,以1 cm为界,将瘤周水肿区分为近瘤区和远瘤区,分别测量不同级别脑胶质瘤瘤周水肿近瘤区及远瘤区的相对表观扩散系数(relative apparent diffusion coefficient,rADC)值、相对脑血容量(relative cerebral blood volume,rCBV)值.分别对不同级别脑胶质瘤瘤周水肿近瘤区及远瘤区rADC值、rCBV值进行比较.结果 高级别胶质瘤组瘤周水肿近瘤区的rADC值分别为(1.44±0.21),明显高于低级别胶质瘤组的(1.18±0.40),差异有统计学意义(P＜0.05);远瘤区rADC值组间比较,差异无统计学意义(P＞0.05).高级别胶质瘤组瘤周水肿近瘤区rCBV值(3.42±1.01),明显高于低级别胶质瘤组的(1.99±0.79),差异有统计学意义(P＜0.05).远瘤区rCBV值组间比较,差异无统计学意义(P＞0.05).ROC曲线分析显示,瘤周水肿近瘤区rADC诊断高级别胶质瘤的最佳诊断阈值为1.36,其敏感度为97.4％,特异度为73.8％,准确率为86.7％;近瘤区rCBV诊断高级别胶质瘤的最佳诊断阈值为2.97,其敏感度为92.3％,特异度为77.8％,准确率为85.9％.结论 胶质瘤瘤周水肿近瘤区的rADC值、rCBV值有助于胶质瘤的分级,且诊断准确性较高.     

磁共振扩散加权成像在肝脏占位性病变中的应用

目的:探讨磁共振扩散加权成像(DWI)在肝脏占位性病变中的应用价值。方法:对30例无肝脏病变者的正常肝组织及105例164个肝占位性病灶(肝囊肿22例40个病灶,肝血管瘤37例40个病灶,肝细胞癌23例32个病灶,肝转移瘤15例35个病灶,肝脓肿8例17个病灶)行DWI,并测量表观扩散系数值(ADC值)。结果:正常肝组织的ADC值为(1.42±0.08)×10-3mm2/s。肝囊肿、肝血管瘤、肝细胞癌、肝转移瘤及肝脓肿的ADC值分别为(4.33±0.25)×10-3、(2.43±0.25)×10-3、(1.63±0.08)×10-3、(1.78±0.07)×10-3、(1.18±0.11)×10-3mm2/s,各组之间差异均存在统计学意义(P<0.01)。结论:分析DWI及测量ADC值对肝脏占位性病变的鉴别诊断有一定价值,有利于小病灶的显示,可作为肝脏MRI检查的常规序列之一,但不利于小病灶的定性诊断。     

宫颈癌的磁共振扩散加权成像研究

目的:分析宫颈癌(UCC)和正常子宫颈扩散加杈成像(DWI)的特点,研究宫颈癌放化疗前后表观扩散系数(ADC)值的变化,探讨DWI在UCC诊断及放化疗疗效监测方面的价值.方法:对临床经病理确诊的50例宫颈癌患者行常规MRI和横断位DWI (b=600、800、1000 s/mm2)检查,同时收集年龄与实验组相匹配的健康志愿者或因非宫颈疾病行盆腔MRI检查者40例,对正常子宫颈行常规MRI和横断位DWI(b=600、800、1 000 s/mm2)检查.比较正常宫颈和UCC病灶的ADC值;比较UCC放化疗前后的ADC值.结果:①b=600 ～0 s/mm2,800 ～0 s/mm2,1000～0 s/mm2时,正常子宫颈平均ADC值分别为[(1.799±0.220)×10-3 mm2/s]、[(1.714±0.227)×10-3 mm2/s]、[(1.654±0.223)×10-3 mm2/s],UCC放化疗前的平均ADC值分别为[(0.901±0.120)×10-3 mm2/s]、[(0.870±0.133)×10-3 mm2/s]、[(0.840±0.130)×10-3 mm2/s],UCC放化疗后的平均ADC值分别为[(1.543±0.225)×10-3 mm2/s]、[(1.470±0.209)×10-3 mm2/s]、[(1.404±0.197)×10-3 mm2/s].②正常子宫颈和UCC放化疗前、后的平均ADC值差异均有统计学意义(P=0.000);放化疗后ADC值较放化疗前明显升高,两者差异有统计学意义(P=0.000).③b值高低影响正常子宫颈和UCC的ADC值,b值越小,ADC值越大.结论:DwI对UCC显示敏感性高,b值选择800 s/mm2和1 000 s/mm2较理想.DWI能够区分UCC和正常宫颈组织,可用于UCC侵犯范围的评价,DWI对UCC放化疗疗效的监测具有重要的临床意义.     

磁共振扩散加权成像在颅脑疾病诊断中的应用

扩散加权成像（diffusion weighted imaging，DWI）是目前唯一能在活体上进行分子扩散测量，分析病变内部结构及组织成份，反映活体组织功能状态的功能性成像。1986年Libenhan将DWI技术应用于临床后，对扩散成像的临床应用研究已经近20年。最早主要用于急性脑缺血的研究，现已成为脑卒中检查的一种常规序列。随着磁共振硬件、软件及计算机技术的发展，     

磁共振全身扩散加权成像技术在恶性肿瘤中的应用

目的评价全身磁共振扩散加权成像(whole-body magneticresonance diffusion-weighted imaging,WB-DWI)在恶性肿瘤疾病中的应用价值。方法20例健康体检者及70例恶性肿瘤患者行WB-DWI检查。70例患者中乳癌34例,1例为术前检查,其余均为术后复查病例;血液系统疾病13例,粒细胞性白血病3例,非何杰金氏淋巴瘤5例,多发性骨髓瘤5例;卵巢癌8例;子宫内膜癌4例;肺癌、大肠癌、胃癌各3例;前列腺癌、食道癌各1例。其中1例非何杰金氏淋巴瘤做了2次WB-DWI检查。原发灶皆经病理组织学确诊,转移瘤的诊断综合组织病理学结果及多种影像学检查而定。对WB-DWI图像、常规MR图像和CT图像行帧对帧对比分析。分别测量正常淋巴结和恶性淋巴结的ADC值,并进行统计学分析。结果WB-DWI检出健康者良性病灶5例,70例患者中,除去37例无转移灶及3例全身骨髓弥漫扩散受限外,30例WB-DWI共检出原发灶以外异常信号136处,其中真阳性、假阳性分别为118处和18处,假阴性15处,检出率为86.8%(118/136)。经x2检验正常淋巴结和恶性淋巴结的ADC值存在显著差异(p0.05)。结论WB-DWI对恶性肿瘤性疾病的分期、术后随访及疗效评价有一定的价值。     

磁共振扩散加权成像的研究进展及临床应用

磁共振扩散加权成像(DWI)是磁共振成像(MRI)功能成像之一,是一种通过检测活体组织内水分子的扩散运动,从分子运动水平上分析病变内部结构及组织成分的无创性功能成像方法,其能够提供活体水分子运动、分布的特征信息,是目前进行水分子测量与成像的唯一无创性方法。最初DWI主要应用于中枢神经系统疾病的诊断,如脑卒中、脑脓肿、脑炎以及脑肿瘤,现已逐渐成为脑、肝脏和前列腺等脏器MRI扫描的常规组成部分。体素内不相干运动成像也逐渐被应用于临床研究中,并在腹部器官疾病方面亦获得了一定研究进展。     

磁共振扩散加权成像对肝脏局灶性病变的评价

磁共振扩散加权成像（diffusion weighted imaging,DWI）是一种检测水分子扩散状态的磁共振成像方法,它利用组织间弥散系数不同产生的组织对比进行成像,是磁共振功能成像的重要组成部分,可以在分子水平对生物体的组织结构和功能状态进行无创性检查。最初主要应用在中枢神经系统对早期脑梗死的诊断。     

FEASIBILITY OF DIAGNOSING AND STAGING LIVER FIBROSIS WITH DIFFUSION WEIGHTED IMAGING

Objective To assess the clinical feasibility of diagnosing and staging liver fibrosis by apparent diffusion coefficient （ADC）.
Methods Totally, 43 patients （mean age 29.3 years） with chronic hepatitis by liver biopsy and 7 healthy controls （mean age 39.9 years） underwent liver diffusion weighted imaging （DWI） with four b values： 0, 200, 500, and 1000 s/mm^2 respectively. The liver fibrosis was staged according to Ishak fibrosis stage. The ADC value of liver fibrosis patients and healthy controls was compared. The correlation of ADC value and liver fibrosis staging was analyzed.
Result The histological staging showed 8 stage 1 patients, 10 stage 2 patients, 6 stage 3 patients, 9 stage 4 patients, 8 stage 5 patients and 2 stage 6 patients. The mean ADC value of liver fibrosis patients was significantly lower than that of healthy controls except for stage 1 group （P 〈 0.05）. There was a negative correlation between liver fibrosis staging and ADC value （r = -0.697 with b=500 s/mm^2, P 〈 0.01）. Receiver operating characteristic （ROC） curve of ADC value of advanced liver fibrosis （Ishak stage F3 and higher） showed that area under curve = 0.913, 0.825, and 0.794 with b = 500, 1000, and 200 s/mm^2, respectively （95% confidence interval： 83.6%-99.0%, 70.7%-94.3%, 66.5%- 92.4%; P 〈 0.05）. When b value was 500 s/mm^2, the sensitivity （84%） and specificity （80%） of DWI for diagnosis of advanced liver fibrosis were the highest.
Conclusion DWI is proved to be a useful clinical tool in the quantitative evaluation of liver fibrosis and in the prediction of the process of liver fibrosis with the recommendable b value （500 s/mm^2）.     

EVALUATION OF CIRRHOTIC LIVER WITH PERFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING： A PRELIMINARY EXPERIMENTAL STUDY IN ANIMAL MODELS WITH HALF-LIVER CIRRHOSIS

THE liver has a dual blood supply comprising thehepatic artery delivering arterial blood from theheart and the portal vein delivering venous blooddraining the gastrointestinal tract·The liver perfusion isone of the most important factors determining hepa…     

正常成人脑组织弥散成像的定量研究

目的研究正常成人脑不同解剖部位的弥散特点,建立脑内不同部位的正常表观弥散系数(apparent diffusion coefficient,ADC)值标准.方法健康志愿者和体检者280例,行弥散加权成像(diffusion weighted imaging),弥散梯度因子(gradient factor)b值选用0,1000 s/mm2.结果正常成人脑内各组织平均 ADC值测量(×10-3mm2/s):皮层灰质为 0.84±0.15,皮层白质为 0.71±0.12,尾状核头为 0.74±0.19,豆状核为 0.72±0.18,丘脑为 0.75±0.21,内囊后肢为 0.68±0.17,半卵圆中心为 0.72±0.22,胼胝体膝部和压部分别为 0.71±0.10、0.72±0.10,侧脑室体部为 2.85±0.27.正常成人脑内两侧不同解剖部位及两年龄、性别组的 ADC值无显著性差异.结论通过定量测量正常成人脑部ADC值,获得成年国人的正常ADC值,为鉴别病理改变提供基础对照.     

Tei指数综合评价肝硬化患者心功能及其与Child—Pugh的相关性研究

目的 应用心肌运动指数即Tei指数综合评价肝硬化患者心功能及其与Chlid-Pugh的相关性.方法 肝硬化患者76例,按Child-Pugh肝功能分级标准分为Child A组（n=31）、Child B组（n=25）和Child C组（n=20）,健康志愿者30例作对照组,应用脉冲多普勒方法,计算左、右心室的Tei指数,进行组间比较,并与Child-Pugh分级做相关分析.结果 肝硬化失代偿期（Child B级、Child C级）组左心室的Tei指数及等容舒张时间/心室射血时间（isovolumic relaxation time/ejection time,IRT/ET）与对照组比较均明显升高（P＜0.05）;右心室的Tei指数及IRT/ET与对照组比较,差异无统计学意义（P＞0.05）; 左心室Tei指数与Chlid-Pugh分级呈正相关（r=0.625,P＜0.01）.结论 肝硬化患者存在左室收缩功能和舒张功能不全,与肝功能损害严重程度相一致.     

EXPERIMENTAL STUDY OF INFLAMMATORY AND METASTATIC LYMPH NODES WITH DIFFUSION WEIGHTED IMAGING ON ANIMAL MODEL： COMPARISON WITH CONVENTIONAL METHODS

Objective To investigate the feasibility of magnetic resonance （MR） diffusion weighted imaging （DWI） in discriminating inflammatory from VX2 carcinoma metastatic lymph nodes in rabbit model.
Methods Twenty New Zealand white rabbits were randomly divided into 2 groups. Complete Freund＇s adjuvant was injected into the bilateral dorsal footpads to set up ipsilateral lymphadenitis model （n = 10）, and the other 10 rabbits received a subcutaneous implantation of VX2 tumor cell suspension （1.5×10^7 cells/mL） in both thighs to set up metastatic lymph node model. MR imaging scan covering the popliteal fossa and lilac fossa including short time inversion recovery echo-planar imaging DWI （STIR-EPI-DWI）, Tl-weighted imaging （T1WI） and T2-weighted imaging （T2WI） was performed 2 weeks after injection. T2WI signal intensity （SI）, DWI SI, long/short axial ratio （LSR） and apparent diffusion coefficient （ADC） values of the lymph nodes were evaluated in all cases. Right after MR imaging scan, popliteal and iliac fossa lymph nodes were collected for hematoxylin-eosin staining.
Results Totally 33 lymph nodes larger than 5 turn, including 22 inflammatory and 11 metastatic ones, were successfully isolated and taken into pathological analysis. LSR showed no significant difference between the inflammatory and malignant lymph nodes （P 〉 0.05）. Both benign and malignant lymph nodes appeared iso-intense on TlWI and hyperintense on both T2WI and DWI images with an even lower TlWI and higher T2WI SI core at the hilum. Both T2WI and DWI SI showed no significant difference between two pathological groups （P 〉 0.01） in popliteal fossa. The mean ADC value of inflammatory nodes [（1.199±0.281） ×10^-3 mm^2/s] was significantly higher than that of metastatic nodes [（0.858 ± 0.090） ×10^-3 mm^2/s, P 〈 0.01]. On ADC map, a high ADC value central area could be seen in most of the lymph nodes no matter benign or malignant. ADC value gave out the largest area under curve （AUCADC =     

PRELIMINARY APPLICATION OF WHOLE BODY DIFFUSION WEIGHTED IMAGING IN SCREENING METASTASIS

Objective To investigate the feasibility of whole body diffusion weighted imaging （WB-DWI） in screening metastasis.
Methods WB-DWI was performed in 24 patients diagnosed with various types of primary tumors. The three-dimensional maximum intensity projection reconstruction and black-and-white flip technique were used to observe metastatic lesions, and the results were compared with those of bone scintigraphy.
Results By WB-DWI scanning sequence at b = 800 s/mm^2, all the bone lesions found by bone scintigraphy in the cohort were well identified, and other lesions of soft tissue and organs were also well demonstrated. Its screening capability was equivalent with bone scintigraphy in screening metastases in bones （P = 0.062）.
Conclusion WB-DWI was practicable with the parameter settings attempted in metastases screening.     

WHOLE BODY DIFFUSION WEIGHTED IMAGING： A NEW ERA OF ONCOLOGICAL RADIOLOGY

Cancer has become the leading cause of mortality in the urban area of China. Whole body diffusion weigntea imaging （WB-DWI）, also known as virtual positron emission tomography, has gradually become accepted as an image tool in tumor localization, characterization, staging and monitoring response to therapy or tumor recurrence. Our article aimed to summarize the limited initial clinical use of WB-DWI in the referred area, and to analyze the most potential advantage of WB-DWI in therapeutic monitoring and tumor staging. WB-DWI as a highly sensitive, completely non-invasive, well-tolerated and low price technique has a promising furture in tumor assessment. Profound clinical study is necessary for its further application improvement.     

AGE-RELATED CHANGES OF BONE MARROW OF NORMAL ADULT MAN ON DIFFUSION WEIGHTED IMAGING

Objective To investigate the signal intensity and apparent diffusion coefficient （ADC） of bone marrow of normal adult man on diffusion weighted imaging （DWI）.
Methods Fifteen healthy volunteers and thirty-eight patients with benign prostatic hyperplasia or normal prostate were enrolled in this study, with age range 28-82 years old （mean 55.26 ± 18.05 years）. All people were examined with large field DWI on a 3.0T magnetic resonance scanner, which ranges from the top of head to the lower limb. The signal-to-noise ratio （SNR） on the DWI and ADC of lumber vertebra at renal hilum level, left ilium and superior segment of left femur were measured. The measured SNR and ADC value of the above sites were compared by one way analysis of variance and their correlations with age were investigated by Pearson＇s correlation analysis.
Results The SNR of lumber vertebra, left ilium and left femur showed no significant difference （F = 0.271, P = 0.763）. The SNR of lumber vertebra （r = 0.309, P = 0.024） and left ilium （r = 0.359, P = 0.008） showed positive correlation with age, while the SNR of left femur showed no correlation with age （r = -0.163, P = 0.283）. The ADC of lumber vertebra [（0.617 ± 0.177） ×10^-3 mm^2/s] was significantly higher than that of left ilium [（0.404 ± 0.112） ×10^-3 mm^2/s, P 〈 0.001] and left femur [（0.362 ± 0.092） ×10^-3 mm^2/s, P 〈 0.001], while the ADC of left ilium and left femur had no significant difference. The ADC of lumber vertebra, left ilium and left femur showed no correlation with age.
Conclusion Understanding of age-related changes of normal adult bone marrow on DWI is very important to differentiate the normal bone marrow and abnormal lesions.     

NORMAL APPEARANCE OF LARGE FIELD DIFFUSION WEIGHTED IMAGING ON 3.0T MRI

Objective To evaluate the normal appearance of large field diffusion weighted imaging （DWI） on 3.0T magnetic resonance imaging （MRI）.
Methods Twenty healthy volunteers and thirty patients with benign prostate hyperplasia were included in this study. All patients were examined with large field DWI on 3.0T MRI. Normal tissue appearance was analyzed and apparent diffusion coefficient （ADC） of normal tissue with high signal intensity was measured. The ADC values of bilateral symmetrical tissue were also compared. The ADC values of intervertebral disks of healthy people younger than 50 years and exceeding 50 years were compared.
Results Salivary gland, spleen, kidney, gallbladder, bladder, prostate, seminal vesicle, testis, intervertebral disk, liquid in articular cavity and lymph node showed high signal intensity on large field DWI, while lung, liver and bone showed hypo-signal intensity. The mean ADC values of partial hyperintensity tissue were as followed： parotid gland （1.088 ± 0.114） ×10^-3 mm^2/s, submaxillary gland （1.309 ± 0.189） ×10^-3 mm^2/s, kidney （1.909 ± 0.143）×10^-3 mm^2/s, seminal vesicle （1.669 ± 0.168） ×10^-3 mm^2/s, testis （1.028 ± 0.075） ×10^-3 mm^2/s, spleen （0.963 ± 0.108） ×10^-3 mm^2/s, bladder （2.898 ± 0.267）×10^-3 mm^2/s, prostate （1.448 ± 0.132） ×10^-3 mm^2/s, intervertebral disks （1.360 ± 0.140） ×10^-3 mm^2/s. No statistical significance was found between the ADC values of bilateral symmetrical tissues. The difference of ADC values of intervertebral disks of healthy people younger than 50 years [（1.372 ± 0.142） ×10^-3 mm^2/s] and exceeding 50 years [（1.344 ± 0.134）×10^-3 mm^2/s] showed statistical significance （P = 0.040）.
Conclusion Understanding the high signal intensity of normal tissue on large field DWI may help to differentiate the normal tissues and abnormal ones.     

CLINICAL APPLICATION OF BODY DIFFUSION WEIGHTED MR IMAGING IN THE DIAGNOSIS AND PREOPERATIVE N STAGING OF CERVICAL CANCER

Objective To evaluate the clinical impact of body diffusion weighted imaging （DWI） on the diagnosis and preoperative N staging of cervical cancer.
Methods Twenty-four patients （mean age 37.9 years old） with proved cervical cancer by cervical biopsy and 24 female patients with other suspected pelvic abnormalities received preoperative body DWI scan. Results of body DWI were compared with pathological findings. The apparent diffusion coefficient （ADC） values of normal cervix and different pathological types of cervical cancer were compared. ADC value of normal or inflammatory lymph nodes was also compared with that of metastatic ones. Student＇s t test was used for statistical analysis.
Results There were 5 adenocarcinomas and 19 epitheliomas showed with biopsy results, and DWI showed 21 cervical lesions out of them （87.5%）. ADC values of the normal cervix （n = 24）, epithelioma （n = 19）, and adenocarcinoma （n = 5）were （1.73 ± 0.31） × 10^-3, （0.88 ± 0.22） × 10^-3, and （1.08 ± 0.12）× 10^-3 mm^2/s, respectively. Statistical analysis showed significant difference in ADC value between normal cervical tissue and either tumor tissues （both P 〈 0.01）. In patients had lymphadenectomy （n = 24）, totally 67 lymph nodes including 16 metastatic lymph nodes were pathologically analyzed, and DWI showed 66 （98.5%） out of them. ADC values of normal/inflammatory and metastatic lymph nodes were （1.07 ± 0.16） × 10^-3 and （0.77 ± 0.13） × 10^-3 mm^2/s （P 〈 0.01）. Receiver operating characteristic （ROC） curve of ADC value of metastatic lymph node showed that area under curve was 0.961.
Conclusions ADC value in cervical carcinoma is lower than that in normal cervix, and ADC may have predictive value in subtype discrimination. ADC value may improve the preoperative characterization of lymph node metastasis. And at least abdominal and pelvic DWI scan is suggested for N staging evaluation in such patients.