【摘要】 目的:探讨磁共振扩散加权成像(DWI)及表观扩散系数(ADC)值在宫颈癌诊断、分期、病理分型及分级中的应用价值。方法:选取2012年3月~2013年9月在该院妇科住院经临床病理活检证实的Ⅱa期~Ⅳa期宫颈癌患者45例为病例组,行常规磁共振成像(MRI)及DWI检查,同时选取10例正常宫颈组织作为对照组,分别测量并比较ADC值。结果:通过DWI分析,病例组平均ADC值为(0.907±0.127)×10-3mm2/s,对照组为(1.519±0.055)×10-3mm2/s,差异有统计学意义(P<0.05);宫颈鳞癌患者(40例)的平均ADC值为(0.887±0.122)×10-3mm2/s,腺癌患者(5例)为(1.061±0.231)×10-3mm2/s,差异有统计学意义(P<0.05);高分化(G1)、中分化(G2)和低分化(G3)宫颈鳞癌患者的ADC值分别为(1.012±0.128)×10-3mm2/s、(0.943±0.081)×10-3mm2/s和(0.837±0.104)×10-3mm2/s,G1与G3、G2与G3组间比较,差异均有统计学意义(t=3.523,P<0.05;t=2.729,P<0.05),G1与G2组间比较,差异无统计学意义(t=1.293,P>0.05);Ⅱa、Ⅱb、Ⅲa、Ⅲb及Ⅳa期肿瘤患者的平均ADC值分别为(0.936±0.162)×10-3mm2/s、(0.997±0.069)×10-3mm2/s、(0.797±0.417)×10-3mm2/s、(0.857±0.109)×10-3mm2/s和(0.903±0.217)×10-3mm2/s,Ⅱa与Ⅲa,Ⅱb与Ⅲa、Ⅲb之间比较,差异均有统计学意义(t=2.392,P<0.05;t=5.434,P<0.05;t=4.332,P<0.05),余下组间比较,差异无统计学意义(P>0.05)。结论:DWI及ADC值能够鉴别正常宫颈及宫颈癌组织,有助于宫颈癌的诊断,ADC值在宫颈癌的诊断、分期、病理分型及分级中有一定的应用价值。更多还原

【Abstract】 Objective: To explore the application values of diffusion- weighted imaging( DWI) and apparent diffusion coefficient( ADC) in diagnosis,staging,pathological typing and grading of cervical cancer. Methods: Forty- five patients diagnosed as cervical cancer of stage Ⅱa- Ⅳa by clinicopathological biopsy in gynecological department of the hospital from March 2012 to September 2013 were selected as case group,then conventional MRI and DWI scanning were performed; 10 cases with normal cervix were selected as control group,ADC values in the two groups were measured and compared. Results: The mean ADC values in case group and control group were( 0. 907 ± 0. 127) × 10- 3mm2/ s and( 1. 519 ± 0. 055) × 10- 3mm2/ s,respectively,there was statistically significant difference between the two groups( P < 0. 05); in case group,the mean ADC values in 40 patients with cervical squamous cell carcinoma and 5 patients with cervical adenocarcinoma were( 0. 887 ± 0. 122) × 10- 3mm2/ s and( 1. 061 ± 0. 231) × 10- 3mm2/ s,respectively,there was statistically significant difference between the two groups( P < 0. 05); the mean ADC values in patients with well- differentiated,moderate- differentiated and poor- differentiated cervical squamous cell carcinoma were( 1. 012 ± 0. 128) × 10- 3mm2/ s,( 0. 943 ± 0. 081) × 10- 3mm2/ s and( 0. 837 ± 0. 104) × 10- 3mm2/ s,respectively; there was statistically significant difference in the mean ADC value between stage G1 and stage G3( t = 3. 523,P < 0. 05); there was statistically significant difference in the mean ADC value between stage G2 and stage G3( t = 2. 729,P < 0. 05); there was no statistically significant difference in the mean ADC value between stage G1 and stage G2( t = 1. 293,P > 0. 05); the mean ADC values in cervical cancer patients of stages Ⅱa,Ⅱb,Ⅲa,Ⅲb and Ⅳa were( 0. 936 ± 0. 162) × 10- 3mm2/ s,( 0. 997 ±0. 069) ×10- 3mm2/ s,( 0. 797 ± 0. 417) × 10- 3mm2/ s,( 0. 857 ± 0. 109) × 10- 3mm2/ s and( 0. 903 ± 0. 217) × 10- 3mm2/ s,respectively; there was statistically significant difference in the mean ADC value between stage Ⅱa and stage Ⅲa( t = 2. 392,P < 0. 05);there was statistically significant difference in the mean ADC value between stage Ⅱb and stage Ⅲa( t = 5. 434,P < 0. 05); there was statistically significant difference in the mean ADC value between stage Ⅱb and stage Ⅲb( t = 4. 332,P < 0. 05); there was no statistically significant difference among the other groups( P > 0. 05). Conclusion: DWI and ADC value can distinguish cervical cancer and normal cervical tissue,which are helpful on diagnosing cervical cancer. ADC value has a certain application value in diagnosis,staging,pathological typing and grading of cervical cancer.更多还原