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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。
Objective: To investigate the value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) values in the diagnosis, staging, pathological classification and classification of cervical cancer. Methods: From March 2012 to September 2013, 45 cases of stage Ⅱa-Ⅳa cervical cancer confirmed by clinicopathological biopsy in the gynecological hospital of our hospital from March 2012 to September 2013 were selected as the case group underwent conventional magnetic resonance imaging (MRI) and DWI examination. Ten normal cervical tissues were selected as the control group, and the ADC values were measured and compared. Results: By DWI analysis, the mean ADC value was (0.907 ± 0.127) × 10-3mm2 / s in case group and (1.519 ± 0.055) × 10-3mm2 / s in control group, with statistical significance (P <0.05). The mean ADC value was (0.887 ± 0.122) × 10-3mm2 / s in cervical squamous cell carcinoma patients (40 cases) and (1.061 ± 0.231) × 10-3mm2 / s in adenocarcinoma patients, the difference was statistically significant (1.012 ± 0.128) × 10-3mm2 / s, (0.943 ± 0.081) × (T = 3.523, P <0.05; t = 2.729, P <0.05), and there was significant difference between G1 and G3, G2 and G3 groups (P < 0.05). There was no significant difference between G1 and G2 (t = 1.293, P> 0.05). The average ADC value of tumor in groupⅡa, Ⅱb, Ⅲa, Ⅲb and Ⅳa was (0.936 ± 0.162) × 10 (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, Ⅱa and Ⅲa, Ⅱb and Ⅲa, Ⅲb, the differences were statistically significant (t = 2.392, P0.05; t = 5.434, P < Between the two groups, the difference was not statistically significant (P> 0.05). Conclusions: DWI and ADC value can identify normal cervical and cervical cancer tissues and contribute to the diagnosis of cervical cancer. ADC value has certain value in the diagnosis, staging, pathological classification and classification of cervical cancer.