3.0T磁共振DWIBS诊断宫颈癌转移性淋巴结初探

目的探讨3.0T磁共振背景抑制弥散加权成像(DWIBS)在子宫颈癌转移性淋巴结诊断中的应用价值。方法回顾性分析行全宫切除加盆腔淋巴结清扫手术的25例子宫颈癌术前病例。采用方差分析比较子宫颈癌原发病灶及转移性、非转移性淋巴结的ADC值;采用两组随机对照t检验对转移性及非转移性淋巴结的ADC值、长径、短径及短径/长径比分别进行统计学分析。结果 (1)25例子宫颈癌病例中原发病灶25个,转移性淋巴结17个,非转移性淋巴结140个,均经手术病理证实;(2)子宫颈癌原发灶、转移性淋巴结和非转移性淋巴结三者之间的ADC值比较有统计学差异(F=7.93,P=0.001)。子宫颈癌原发灶与转移性淋巴结的ADC值比较无统计学差异(t=-0.75,P=0.456),子宫颈癌原发灶与非转移性淋巴结的ADC值比较有统计学差异(t=4.68,P0.001);(3)转移性及非转移性淋巴结ADC值分别为(0.86±0.36)×10~(-3)mm~2/s和(1.12±0.34)×10~(-3)mm~2/s,长径分别为1.51±0.41cm和1.19±0.36cm,短径分别为1.16±0.35cm和0.77±0.22cm,短径/长径比率分别为0.78±0.17和0.68±0.19,两两比较均有统计学差异。结论 3.0T磁共振DWIBS的ADC值测量能够定量反映转移性及非转移性淋巴结的弥散受限程度,结合淋巴结的短径、长径等综合评价可以提高转移性淋巴结的诊断准确性。

Preliminary results of diagnosing lymph node metastasis in cervical cancer using DWIBS at 3T MRI

Objective To evaluate the efficacy of diffusion-weighted imaging with background suppression （DWIBS） at 3T magnetic resonance （MR） for diagnosing lymph node metastasis in cervical cancer. Methods This retrospective analysis included 25 patients with cervical cancer who underwent MR examination and were treated by hysterectomy and lymphadenectomy. ADC values of the primary tumors, metastatic and non-metastatic lymph nodes were compared by analysis of variance. ADC values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of metastatic and non-metastatic lymph nodes were compared using Student t-test. Results 25 primary tumors, 17 metastatic lymph nodes and 140 non-metastatic lymph nodes were histologically confirmed in 25 patients with cervical cancer. The differences of ADC values between primary tumors, metastatic and non-metastatic lymph nodes were statistically significant （F=7.93, P=0.001 ）. There was no statistically significant difference between primary tumors and metastatic lymph nodes （t=-0.75, P=0.456） whereas the difference between primary tumors and non-metastatic lymph nodes was statistically significant （t =4.68, P 〈0.001）. The ADC values （0.86±0.36×10-3 mm2/s, 1.12±0.34×10-3 mm2/s）, long-axis diameters （1.51＋0.41 cm, 1.19_＋0.36 cm）, short-axis diameters （1.16± 0.35 cm,0.77±0.22 cm）, ratio of short- to long-axis diameters （0.78±0.17, 0.68±0.19） of metastatic and non-metastatic lymph nodes were significantly different. Conclusion Combination of size and ADC value of lymph nodes using DWIBS at 3T MR is useful for diagnosing lymph node metastasis in cervical cancer.