双指数模型DWI对宫颈癌分期及分级诊断的价值

doi:DOI:10.12117/jccmi.2018.12.010

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摘要目的：探讨双指数模型DWI在宫颈癌分期、分级诊断中的应用价值。方法：对经手术病理证实的65例宫颈癌患者的临床影像学资料进行回顾分析，就表观扩散系数（ADC）、慢速表观扩散系数（ADCslow）、快速表观扩散系数（ADCfast）、快速扩散成分所占比（Ffast）等单指数模型及双指数模型DWI参数在宫颈癌分期、分级中的差异进行比较。结果：65例宫颈癌中，Ⅱa期以上出现宫旁浸润患者的ADCslow及ADC均小于Ⅱa期及以下无宫旁浸润患者（包括Ⅱa期），差异具有统计学意义（P＜0.05）。ADCfast及Ffast均高于非浸润组，差异无统计学意义（P＞0.05）。宫颈高分化鳞癌或腺癌的ADCslow及ADC均高于中、低分化鳞癌或腺癌，差异均具有统计学意义（P＜0.05）。而各种级别宫颈鳞癌或腺癌的ADCfast、Ffast均无明显差异。ROC曲线分析显示ADCslow在宫颈癌分期、分级诊断中效能最高。结论：ADCslow有助于评估宫颈癌的分期与分级。

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	李君1
	吴献华2
	冯峰1
	李洪江1
	夏淦林1

关键词 ：宫颈肿瘤, 磁共振成像

Abstract：Objective: To investigate the value of bi-exponential model of intravoxel incoherent motion(IVIM) in diagnosis of different stages, pathological types and subtypes of cervical cancer. Methods: Sixty-five patients with pathological diagnosis of cervical cancer were collected. Apparent diffusion coefficient(ADC), slow apparent diffusion coefficient(ADCslow), fast apparent diffusion coefficient(ADCfast) and fraction of ADCfast(Ffast) were recorded using mono-exponential signal decay model and bi-exponential signal decay model, which were then compared statistically between different stages, pathological types and subtypes. Results: In cervical cancer group, ADCslow of infiltration group was lower than non infiltration group, with statistically significant difference(P<0.05). ADCfast and Ffast of infiltration group were higher than non infiltration group, and the difference were not statistically significant(P>0.05). ADCslow of squamous cell carcinoma was lower than adenocarcinoma cell carcinoma. ADCfast and Ffast of squamous cell carcinoma were higher than adenocarcinoma cell carcinoma, and the difference was statistically significant(P<0.05). ADCslow of cases of high differentiation was higher than cases of middle～low differentiation, with statistically significant difference(P<0.05), while ADCfast and Ffast were not statistically significant(P>0.05). Receiver operating characteristic curve analysis showed that ADCslow was the most effective in diagnosis cervical cancer of different pathological types and subtypes. Conclusion: ADCslow has a high value in diagnostic cervical cancer of different stages and subtypes.

Key words： Cervix neoplasms Magnetic resonance imaging

收稿日期: 2018-01-08

PACS:	Ｒ737.33
	Ｒ445.2

通讯作者: 冯峰，南通市肿瘤医院南通大学附属肿瘤医院放射科，226361。

作者简介: 李君（1986-），女，江苏南通人，主治医师。E-mail：2387267311@qq.com

引用本文:

李君1，吴献华2，冯峰1，李洪江1，夏淦林1. 双指数模型DWI对宫颈癌分期及分级诊断的价值[J]. 中国临床医学影像杂志, 2018, 29(12): 876-880.
LI Jun1, WU Xian-hua2, FENG Feng1, LI Hong-jiang1, XIA Gan-lin1. The value of bi-ponential model DWI in diagnosis of different stages, pathological types and subtypes of cervical cancer. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(12): 876-880.

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http://www.jccmi.com.cn/CN/DOI:10.12117/jccmi.2018.12.010 或 http://www.jccmi.com.cn/CN/Y2018/V29/I12/876

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