摘要
目的探讨体素内不相干运动扩散加权成像(IVIM-DWI)和磁共振动态增强成像(DCE-MRI)对Ⅱ期宫颈癌宫旁浸润的诊断价值。方法搜集经手术理证实的41例Ⅱ期宫颈癌患者,分为宫旁浸润17例和未浸润24例两组,术前分别行盆腔MRI平扫、IVIM-DWI和DCE-MRI检查。测量的参数值包括肿:瘤体积;IVIM-DWI参数,包括标准表观扩散系数(ADC)、慢速表观扩散系数(D)、快速表观扩散系数(D*)和灌注分数(f);DCE-MRI参数,包括容量转运常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积分数(Ve)。两组之间的肿瘤体积、IVIM-DWI和DCE-MRI参数值比较采用单因素方差分析,存在统计学意义的参数值采用ROC曲线计算最佳诊断阈值。结果Ⅱ期宫颈癌宫旁浸润组和未浸润组肿瘤体积存在统计学意义(P值均<0.05)。两组的IVIM-DWI参数D值、D*值和f值差异有统计学意义(F值分别为30.487、6.752和8.983,P值均<0.05),ADC值差异无统计学意义(P>0.05)。D值、D*值和f值诊断宫旁浸润的曲线下面积(AUC)分别为0.140、0.680和0.745,排除AUC小于0.5的D值,则D*值和f值诊断阈值分别为33.65 mm2/s(特异性和敏感性分别为77.4%和60.9%)和0.226(特异性和敏感性分别为83.9%和65.2%)。浸润组和未浸润组DCE-MRI参数Ktrans值、Kep值和Ve值差异存在统计学意义(F值分别为45.20、125.42和85.32,P值均<0.05),3个参数值诊断宫旁浸润的AUC分别为0.896、0.864和0.885,诊断阈值分别为0.272(特异性和敏感性分别为74.2%和95.7%)、0.554(特异性和敏感性分别为67.7%和100%)、0.558(特异性和敏感性分别为90.3%和78.3%)。结论IVIM-DWI和DCE-MRI参数值对Ⅱ期宫颈癌宫旁浸润具有一定的诊断价值,可辅助常规MRI评估宫旁浸润。
Objective To investigate the value of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis of stageⅡcervical cancer with parametrium invasion.Methods Forty-one patients with stageⅡcervical cancer confirmed by surgical pathology were enrolled in our hospital,containing parametrium invasion(n=17)and parametrium non-invasion(n=24).Plain MRI,IVIM-DWI and DCE-MRI were preoperatively performed.The optimal maps of IVIM-DWI parameters(ADC,D,D*,f)and DCE-MRI parameters(Ktrans,Kep,Ve),were reconstructed.All parameters of the two groups were analyzed by one-way anaylsis variance.The optimal cut-off values of parameters with statistical significance were acquired by receiver operator characteristic curve.Results The difference of volumes of stageⅡcervical cancer with parametrium invasion and without parametrium invasion had statistical significance.There were a significant differences of D,D*and f values of the two groups(F=30.487,6.752,and 8.983,P<0.05).On the other hand,there was no difference of ADC values(P>0.05).Areas of D,D*and f values under ROC curves were 0.140,0.680,and 0.745,respectively.The diagnostic threshold of D*and f values was 33.65 mm2/s(specificity=77.4%,sensivity=60.9%)and 0.226(specificity=83.9%,sen-sivity=65.2%),respectively.There was a significant difference of Ktrans,Kep and Ve values of the two groups(F=45.20,125.42 and 85.32,P<0.05).Areas of Ktrans,Kep and Ve values under ROC curves in the diagnosis of cervical cancer with vaginal fornix invasion were 0.896,0.864 and 0.885,respectively.Their diagnostic thresholds were 0.272 mm2/s(specificity=74.2%,sensivity=95.7%),0.554(specificity=67.7%,sensivity=100%),and 0.558(specificity=90.3%,sensivity=78.3%),respectively.Conclusion The IVIM-DWI and DCE-MRI parameter values have certain diagnostic value for parauterine infiltration of stageⅡcervical cancer,and can assist routine MRI in evaluating parauterine infiltration.
作者
李信响
韦超
林婷婷
李乃玉
方昕
唐军
高飞
董江宁
LI Xinxiang;WEI Chao;LIN Tingting(Department of Radiology,the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei,Anhui Province 230031,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第4期720-725,共6页
Journal of Clinical Radiology
基金
安徽省重点研究与开发计划项目(编号:1804h08020294)
中央高校基本科研业务费专项资金资助(编号:YD2150002001)
关键词
体素内不相干运动
动态增强成像
宫颈癌
宫旁浸润
Intravoxel incoherent motion
Dynamic contrast-enhanced magnetic resonance imaging
Cervical cancer
Parametrium invasion
作者简介
通讯作者:董江宁。
