【摘要】 目的 分析三维能量多普勒超声（3D-PDU）联合MR弥散加权成像（DWI）术前鉴别国际妇产联盟（FIGO）ⅠA、ⅠB及ⅡA期宫颈癌的价值。方法 回顾性分析60例经术后病理确诊宫颈癌患者的术前宫颈3D-PDU及DWI,其中FIGO分期ⅠA期19例（ⅠA期组）,ⅠB期26例（ⅠB期组）,ⅡA期15例（ⅡA期组）。比较各组病灶相关血管参数血管形成指数（VI）、血流指数（FI）、血管形成-血流指数（VFI）及DWI参数表观弥散系数（ADC）和指数ADC（eADC）的差异；以logistic回归及受试者工作特征（ROC）曲线评价3D-PDU、DWI及二者联合鉴别FIGOⅠA、ⅠB及ⅡA期宫颈癌的效能。结果 FIGOⅠA、ⅠB及ⅡA期宫颈癌中，随分期级别提高，VI、FI及VFI均逐渐升高，ADC逐渐降低而eADC逐渐升高（P均<0.05）。3D-PDU、DWI及二者联合鉴别宫颈癌FIGOⅠA、ⅠB及ⅡA期宫颈癌模型，即logit（PRE）_3D-PDU、logit（PRE）_DWI及logit（PRE）_联合中，logit（PRE）_联合模型判断宫颈癌FIGO分期的曲线下面积（AUC）为0.89,大于logit（PRE）_3D-PDU及logit（PRE）_DWI（0.78、0.75,Z=4.73、3.55,P均<0.05）,其诊断敏感度及特异度亦均高于logit（PRE）_3D-PDU及logit（PRE）_DWI（P均<0.05）。结论 三维能量多普勒超声联合DWI可于术前有效鉴别FIGOⅠA、ⅠB及ⅡA期宫颈癌。更多还原

【Abstract】 Objective To explore the value of three-dimensional power Doppler ultrasound（3 D-PDU） combined with MR diffusion weighted imaging（DWI） for preoperatively differentiating International Federation of Gynecology and Obstetrics（FIGO） ⅠA, ⅠB and ⅡA stage cervical cancers. Methods Data of 3 D-PDU and DWI in 60 patients with cervical cancer confirmed by postoperative pathology, including 19 cases of FIGOⅠA（stage ⅠA group）, 26 cases of stage ⅠB（stage ⅠB group） and 15 cases of stage ⅡA（stage ⅡA group） were retrospectively analyzed. The vascular parameters of lesions, i.e. vascularization index（VI）, flow index（FI） and vascularization flow index（VFI）, as well as DWI parameters apparent diffusion coefficient（ADC） and exponential ADC（eADC） were compared among groups. According to postoperative pathological results, logistic regression and receiver operating characteristic（ROC） curve were used to analyze the efficacy of 3 D-PDU, DWI and the combination of these two examinations for differentiating of FIGO ⅠA, ⅠB and ⅡA stage cervical cancers. Results Among FIGO ⅠA, ⅠB and ⅡA cervical cancers, with the increase of staging, VI, FI and VFI of the lesions gradually increased, while ADC gradually decreased but eADC increased（all P<0.05）. Among models of logit（PRE）_{3 D-PDU}, logit（PRE）_DWI and logit（PRE）_combination which were obtained with logistic regression analysis to identify FIGO stages of cervical cancers, the area under the curve（AUC） of logit（PRE）_combination for judging FIGO ⅠA, ⅠB and ⅡA stage cervical cancers was 0.89, higher than that of logit（PRE）_{3 D-PDU} and logit（PRE）_DWI（0.78, 0.75, Z=4.73, 3.55, both P<0.05）, with sensitivity and specificity higher than those of logit（PRE）_{3 D-PDU} and logit（PRE）_DWI（all P<0.05）. Conclusion 3 D-PDU combined with DWI could effectively differentiate FIGO ⅠA, ⅠB and ⅡA stage cervical cancers preoperation.更多还原