DWI联合高分辨磁共振T2WI在宫颈癌盆腔淋巴结转移中的应用价值

目的探讨弥散加权成像联合高分辨磁共振T2WI在宫颈癌盆腔淋巴结转移的诊断价值。方法选取2014年10月至2016年2月我院收治的35例宫颈癌患者作为研究对象,所有患者均接经病理检查证实。其中鳞癌33例,腺鳞癌1例,腺癌1例,患者术前均接受DWI联合高分辨磁共振T2WI检查,根据影像结果明确诊断宫颈癌盆腔淋巴结转移情况,并比较转移淋巴结与非转移淋巴结平均表观扩散系数值及最小ADC值是否存在差异。结果术前磁共振检查发现短径超过0.8cm盆腔淋巴结95个,其中明确淋巴结转移108个,与病理证实结果比较无统计学差异(P0.05);转移性淋巴结T2信号强度略高于非转移性淋巴结,但差异不具有统计学意义(P0.05);转移性淋巴结患者平均ADC值以及最小ADC值均明显低于非转移性淋巴结,具有统计学差异(P0.05)。结论 DWI联合高分辨磁共振T2WI成像能够清晰观察宫颈癌盆腔淋巴结转移情况,在鉴别转移淋巴结与非转移淋巴结中准确性较高,同时可通过对淋巴结ADC值的定量分析预测宫颈癌是否发生盆腔淋巴结转移,具有临床应用及推广价值。

The Application Value of DWI Combined with T2WI of High Resolution MRI in Pelvic Lymph Node Metastasis of Cervical Cancer

Objective To discuss the application value of DWI combined with T2WI of high resolution MRI in pelvic lymph node metastasis of cervical cancer.Methods Thirty-two cases with cervical cancer, which admitted in our hospital from October 2014 to February 2016, were selected as the research object. All patients were confirmed cervical cancer by surgery and pathology. Among these cases, 33 cases were squamous cell carcinomas, 1 case was gland scale cancer, 1 case was adenocarcinoma. All patients were preoperatively examined by DWI combined T2WI of high-resolution MRI. The Pelvic lymph node metastasis of cervical cancer was diagnosed according to the result of image and apparent diffusion coefficient (ADC) value of the lymph nodes. The average ADC value and minimum ADC value of non-metastasis lymph nodes and metastasis lymph node were compared.Results MRI examination preoperatively revealed 95 pelvic lymph nodes with short diameter greater than 0.8 cm and 108 lymph nodes with definite metastases, it was no significant different compared with the pathological results(P>0.05). The T2 signal intensity of metastatic lymph nodes was slightly higher than the non-metastatic lymph nodes, but it had no significant difference (P>0.05). The average ADC value and the minimum ADC value of metastatic lymph nodes were significantly lower than that of non-metastatic lymph nodes, the difference was statistically different(P<0.05). Conclusion DWI combined with T2WI of high-resolution MRI can clearly show pelvic lymph node metastasis of cervical cancer. Its accuracy in identification with non-metastasis lymph nodes is higher. At the same time, it can judge whether pelvic lymph node is invaded by cervical cancer with the quantitative analysis of the ADC values. This technique has clinical application value.