弥散加权成像在宫颈癌诊断中的价值

目的:探讨弥散加权成像(DWI)及ADC值在宫颈癌诊断中的价值。方法:对经病理或穿刺活检证实的50例宫颈癌(22例宫颈鳞癌、28例宫颈腺癌)行MRI平扫与增强扫描,及DWI检查,另选20例宫颈无病变女性体查者行MR平扫与DWI检查,在工作站测量感兴趣区的ADC值,对宫颈鳞癌、宫颈腺癌和正常宫颈的ADC值进行统计学分析。结果:宫颈鳞癌、宫颈腺癌和正常宫颈的ADC值随b值的增加,而不断下降,在b值为1000时,分别为0.88±0.06、0.98±0.11、1.80±0.11,宫颈鳞癌与宫颈腺癌的ADC明显低于正常宫颈,差异具有统计学意义(P<0.05),宫颈鳞癌稍低于宫颈腺癌,但差异无统计学意义(P>0.05)。随着b值从200升到2000,鉴出宫颈癌的灵敏度和特异性经历了一个从低到高,再从高到低的过程,在1000时最高,分别为92.7%、89.3%,此时的ADC阈值为1.22。结论:DWI结合ADC值大大提高了对宫颈癌的诊断和鉴别诊断能力。

The Value of Diffusion Weighted Imaging in Diagnosing Cervical Cancer

Objective： To study the value of diffusion weighted imaging（DWl） and ADC values in diagnosing cervical cancer. Methods： 50 patients with cervical cancer（22 cervical squamous cell carcinoma, 28 cervical adenocarcinoma） confirmed by pathology or biopsy, were underwent plain MRI and enhanced MILl, and DWl, 20 women patients of cervix without lesions were underwent plain MR and DW1 examination, and measuring the value of ADC in the regions of interest in the workstation, and the ADC values of cervical cancer and normal cervix were analyzed statistically. Results： The ADC values of cervical squamous cell carcinoma, cervical adenocareinoma and normal cervix declining with b values increasing, when the b values was 1000, the ADC values of them were 0.88±0.06, 0.98±0.11, 1.80±0.11, respectively, the ADC value of cervical squamous cell carcinoma and cervical adenocarcinoma was significantly lower than the normal cervix, and have significant difference （P〈0.05）, cervical squamous cell carcinoma is lower than cervical adenocarcinoma, but have no significant difference （P〉0.05）. With b value from 200 rosing to 2000, the sensitivity and specificity of ADC values in diagnosing cervical cancer, changing from low to high, and high to low, the highest appearing in 1000, were 92.7%, 89.3%, the ADC threshold value was 1.22. Conclusion： Diffusion weighted imaging combined with ADC values, can improve the capability of diagnosis and differential diagnosis in cervical cancer greatly.