摘要
目的：联合利用不同b值的弥散加权成像（DWI），探讨表观弥散系数（ADC）评估宫颈癌各项特性的价值。方法：采用3.0T MRI对112例宫颈癌患者进行盆腔常规MRI、DWI及DCE-MRI扫描，将宫颈癌患者根据以下因素分组：①肿瘤的不同分化程度；②不同肿瘤类型；③术后有无肿瘤复发或转移；④高低级FIGO分期；⑤不同淋巴结状态（0，1，2，3）；⑥不同肿瘤直径（最长径≤2 cm，2~4 cm，＞4 cm）；⑦不同年龄组（30～，40～，50～，60～）。所有ADC值均由b=0，600 s/mm2及b=0，1 000 s/mm2两组ADC图计算得出，比较各组的ADC值。结果：ADC值在低分化宫颈癌（G3）与高中分化宫颈癌（G1/2）之间，在宫颈鳞癌与腺癌之间，在肿瘤术后复发或转移与术后无复发或转移组之间有统计学意义；ADC值在高低级FIGO分期、不同淋巴结状态（0，1，2，3）、不同肿瘤直径及不同年龄组之间无明显差异。结论：ADC值对于预测患者预后（术后是否复发或转移）的价值较高，ADC值可以用来提示宫颈癌患者的组织学级别及类型，尽管仍有一定的交叠，两组b值对于评估宫颈癌不同特性的价值相当。
Abstract
Objective: To evaluate the potential value of apparent diffusion coefficient(ADC) measurement in the assessment of cervical cancer according to different characteristics of cervical cancer. Methods: 112 patients with cervical carcer underwent diffusion-weighted imaging(DWI) in addition to routine MR imaging and dynamic contrast-enhanced MRI(DCE-MRI) on 3.0T MRI. The ADCs were divided into the following groups: ①different pathologic gradings of cervical cancer(G1, G2, G3); ②squamous carcinoma and adenocarcinoma; ③with or without subsequent recurrence or metastasis; ④early stage(FIGOⅠb/Ⅱa) tumor and advanced tumor(FIGOⅡb, Ⅲ and Ⅳ); ⑤cervical cancer with different lymph node status(0, 1, 2, 3); ⑥cervical cancer with different tumor size(greatest diameter≤2 cm, 2~4 cm, ＞4 cm); ⑦cervical cancer with different age range. All ADCs were calculated from b=0, 600 s/mm2 and b=0, 1 000 s/mm2. Results: There was a statistically significant difference between the ADCs of well/moderately differentiated tumors(G1/2) and poorly differentiated tumors(G3), between the ADCs of squamous carcinoma and adenocarcinoma, between the ADCs of patients with and without subsequent tumor recurrence or metastasis on the two groups of ADC maps. There was no significant difference among the ADCs of the cervical cancer when charactirised by other features(FIGO, lymph node status, tumor size and age groups) on the two groups of ADC maps. Conclusion: The ADC values were reliably in predicting prognosis with high diagnostic accuracy. The ADCs can be used to indicate degree and histologic type of cervical cancer although with some overlaps. The diagnostic accuracy was equal on both ADC maps.
关键词
宫颈肿瘤 /
磁共振成像 /
弥散
Key words
Cervix neoplasms /
Diffusion magnetic resonance imaging
邝 菲;陈自谦;钟 群;付丽媛.
ADC值对宫颈癌的评估价值[J]. 中国临床医学影像杂志. 2013, 24(1): 26-31
KUANG Fei;CHEN Zi-qian;ZHONG Qun;FU Li-yuan.
The value of apparent diffusion coefficient in the assessment of cervical cancer[J]. Journal of China Clinic Medical Imaging. 2013, 24(1): 26-31
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