目的：探讨T1 mapping成像在宫颈癌组织分化程度评估中的价值。方法：收集70例经病理证实的宫颈癌患者和30例宫颈正常的其他疾病患者的资料，宫颈癌患者中鳞癌56例，腺癌14例，按照病理分化程度分为中高分化组（49例）和低分化组（21例）。患者均于治疗前行常规MRI、DWI检查，采用Look-Locker序列分别于增强前及增强后5min采集T1 mapping图像，测量肿瘤和正常宫颈的增强前T1弛豫时间（T1pre）、增强后T1弛豫时间（T1post）和ADC值。对比T1pre、T1post和ADC值在肿瘤与正常宫颈、鳞癌与腺癌、中高分化与低分化组间的差别，有统计学意义的参数绘制ROC曲线。结果：肿瘤和正常宫颈的T1pre、T1post、ADC值间差异均有统计学意义（P均＜0.001），鳞癌和腺癌的T1pre、T1post、ADC值间差异均无统计学意义（P均＞0.05），中高分化组的T1post低于低分化组（P＜0.001），中高分化组的ADC值高于低分化组（P=0.002），中高分化组和低分化组的T1pre没有统计学差异（P=0.636），T1post和ADC值鉴别中高分化组和低分化组的ROC曲线下面积分别为0.766、0.736。结论：增强T1 mapping成像可以在一定程度上反映宫颈癌的组织分化程度。
Abstract
Objective: To explore the value of T1 mapping in assessing grades of uterine cervical cancer. Methods: Seventy patients with pathologically proven cervical cancer and 30 patients with normal cervix underwent conventional MRI and DWI before therapy. Seventy cases of cervical cancer, including 56 cases of squamous cell carcinoma and 14 cases of adenocarcinoma, were divided into well/moderately differentiated tumor group(n=49) and poorly differentiated tumor group(n=21) according to the degree of pathological differentiation. Look-Locker sequences were performed pre and post contrast separately at 5 min after Gd-DTPA administration. T1 relaxation times(T1pre and T1post) and ADC of tumor and normal cervix were measured. The differences in the parameters between cervical cancer and normal cervix, tumor types/grades were compared, and ROC curve was drawn with statistically significant parameters. Results: The difference of T1pre, T1post and ADC was statistically significant between cervical cancer and normal cervix(P＜0.001). There was no significant difference in T1pre, T1post and ADC between squamous cell carcinomas and adenocarcinomas. Compared to the well/moderately differentiated tumor group, poorly differentiated tumor group showed increased T1post and decreased ADC(P=0.000 and P=0.002, respectively). No significant difference was observed for T1pre in differentiated grades of tumor. The areas under ROC curve of T1post and ADC for diagnosis of well/moderately and poorly differentiated tumor were 0.766 and 0.736. Conclusion: Enhanced T1 mapping can reflect the degree of tissue differentiation of cervical cancer to a certain extent.
关键词
宫颈肿瘤 /
磁共振成像
Key words
Cervix neoplasms /
Magnetic resonance imaging
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