磁共振体素内不相干运动成像在宫颈癌中的初步应用

目的初步评价1.5 T MR体素内不相干运动成像参数在宫颈癌中的应用价值。方法搜集经术后或活检病理证实的24例宫颈癌患者,另招募30名健康女性作为对照组,均行IVIM成像(b=0~1000 s/mm~2),并分析参数(f、D~*、D、ADC)。两组间分别进行独立样本t检验,采用受试者工作特征曲线下面积评估上述参数值鉴别宫颈癌的能力。结果宫颈癌组的参数f、D~*、D、ADC平均值分别为(25.83±6.12)%,(16.83±4.02)×10~(-3) mm~2/s,(0.95±0.15)×10~(-3) mm~2/s,(1.05±0.17)×10~(-3)mm~2/s。正常健康女性宫颈纤维间质的上述参数平均值分别为(40.87±9.84)%,(17.64±4.80)×10~(-3) mm~2/s,(1.00±0.28)×10~(-3)mm~2/s,(1.56±0.45)×10~(-3)mm~2/s;外侧肌层分别为(36.00±5.99)%,(17.69±4.37)×10~(-3) mm~2/s,(1.24±0.20)×10~(-3)mm~2/s,(1.83±0.54)×10~(-3)mm~2/s。除D~*值外,f、D、ADC值在纤维间质和外侧肌层间差异均有统计学意义(P0.05)。除D~*、D值外,f、ADC值鉴别宫颈癌和纤维间质差异有统计学意义(P0.01),其ROC曲线下面积分别为:0.923、0.912;除D~*值外,f、D、ADC值鉴别宫颈癌和外侧肌层差异均有统计学意义(P0.01),其ROC曲线下面积分别为:0.881、0.887、0.974。结论1.5 T MR体素内不相干运动成像参数在宫颈癌诊断中具有应用价值,并能有效区分正常宫颈纤维间质和外侧肌层。

Preliminary study of intravoxel incoherent motion MR imaging in cervical cancer

Objective To evaluate the intravoxel incoherent motion (IVIM) imaging parameters on 1.5 T MR system for di-agnosing cervical carcinoma. Methods 24 patients with pathologically confirmed cervical cancer and 30 healthy women underwent IVIM imaging with b values of 0-1000 s/mm2. The parameters including f, D*, D, and ADC were determined and compared between the two groups using independent samples t test. The usefulness of these parameters for diagnosing cervical cancer was evaluated by areas under the receiver operating characteristic (ROC) curves. Results The average f, D and ADC values were significantly differ-ent (P<0.05) between that of normal fibrous stroma(40.87±9.84%, 1.00±0.28×10-3 mm2/s, 1.56±0.45×10-3 mm2/s) and lateral mus-cle layer (36.00±5.99%, 1.24±0.20×10-3 mm2/s, 1.83±0.54×10-3 mm2/s) whereas the D* values were not significantly different be-tween that of normal fibrous stroma (17.64±4.80×10-3 mm2/s) and normal lateral muscle layer (17.69±4.37×10-3 mm2/s) in healthy women. The D* (16.83 ±4.02 ×10-3 mm2/s) and D (0.95 ±0.15 ×10-3 mm2/s), f (25.83 ±6.12%) and ADC (1.05 ±0.17 ×10-3 mm2/s) values for differentiating cervical cancer from normal fibrous stroma were significantly different (P<0.01) with areas under the ROC curves of 0.923 and 0.912, respectively. The f, D and ADC values for differentiating cervical cancer from normal lateral muscle layer were also significant (P<0.01) with areas under the ROC curves of 0.881, 0.887, and 0.974, respectively. Conclusion IVIM imag-ing is useful for differentiating cervical cancer from normal fibrous stroma and lateral muscle layer.