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目的探讨MRI扩散加权成像(DWI)的表观扩散系数(ADC)值和相对表观扩散系数(r ADC)值对宫颈癌患者盆腔转移性淋巴结的诊断价值。方法选择44例宫颈癌伴盆腔淋巴结肿大(短径≥0.5 cm)的初诊患者,均行常规MRI及DWI检查,测量肿大淋巴结以及宫颈癌原发灶的ADC值,并计算出相应的r ADC值(淋巴结ADC/癌灶ADC),参照术后病理结果,比较转移性、非转移性淋巴结的ADC值及r ADC值。以受试者工作特征(ROC)曲线评价ADC值以及r ADC值对宫颈癌患者盆腔转移性淋巴结的诊断效能。结果 44例宫颈癌患者,转移性淋巴结63枚、非转移性淋巴结35枚,转移性淋巴结ADC值、r ADC值均低于非转移性淋巴结(P<0.01)。ROC曲线分析结果显示,ADC值曲线下面积为0.812,诊断阈值为0.997×10-3mm2/s,灵敏度、特异度分别为84.13%、71.43%;r ADC值曲线下面积为0.695,诊断阈值为1.169,灵敏度、特异度分别为63.49%、77.14%。结论 ADC值和r ADC值均对宫颈癌患者盆腔转移性淋巴结有较高的诊断价值,但r ADC值的诊断效能并未优于ADC值。
Objective To investigate the value of apparent diffusion coefficient (ADC) and relative apparent diffusion coefficient (r ADC) of MRI diffusion-weighted imaging (DWI) in the diagnosis of pelvic metastatic lymph nodes in patients with cervical cancer. Methods Forty-four newly diagnosed patients with cervical cancer with pelvic lymphadenectasis (short diameter≥0.5 cm) were enrolled in this study. All patients underwent routine MRI and DWI. The ADC values of lymph nodes and cervical cancer were measured and the corresponding r ADC value (lymph node ADC / foci ADC), with reference to postoperative pathological results, ADC value and r ADC value of metastatic, non-metastatic lymph nodes were compared. The receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of ADC values and r ADC values in pelvic metastatic lymph nodes of patients with cervical cancer. Results 44 cases of cervical cancer, 63 cases of metastatic lymph nodes, 35 non-metastatic lymph nodes, metastatic lymph node ADC value, r ADC value were lower than non-metastatic lymph nodes (P <0.01). ROC curve analysis showed that the area under the ADC curve was 0.812, the diagnostic threshold was 0.997 × 10-3mm2 / s, the sensitivity and specificity were 84.13% and 71.43% respectively; the area under the r ADC curve was 0.695 and the diagnostic threshold was 1.169 , Sensitivity and specificity were 63.49% and 77.14% respectively. Conclusion Both ADC value and r ADC value have high diagnostic value for pelvic metastatic lymph nodes in patients with cervical cancer, but the diagnostic value of r ADC value is not superior to ADC value.