DWI在宫颈癌诊断中的应用价值及其与病理相关性

:300052;*腹部放射学DWI刘颖,白人驹*目的(DWI),(apparentdiffusioncoeff-icient,ADC)资料与方法4215MRIDWI,b01000s/mm2,DWIADC,32HE结果DWI,;ADC(0.880.15)10-3mm2/s,ADC(1.500.16)10-3mm2/s,(P0.05);ADC(0.850.13)10-3mm2/s,ADC(0.980.22)10-3mm2/s,(P0.05);ADC(r=-0.711,P=0.000r=-0.778,P=0.000)结论DWI,ADC,,TheApplicationValueofDiffusionWeightedImaginginDiagnosingUterineCervixCancerandItsCorrelationwithPathologyLIUYing,BAIRenjuDepartmentofRadiology,GeneralHospitalofTianjinMedicalUniversity,Tianjin300052,P.R.ChinaAbstractObjectiveToanalyzethediagnosticvalueofdiffusionweightedimaging(DWI)foruterinecervixcancer,investigatethecorrelationbetweenapparentdiffusioncoefficient(ADC)valueandthecellularitydensityandalsothecorre-lationbetweenADCvalueandthegradingoftumor.MaterialsandMethodsConventionalandDWI(diffusionfactorof0and1000s/mm2)wereperformedinforty-twofemalepatientswithuterinecervixcancerandfifteenfemalepatientswithothergynecologicaldiseases.ThesignalintensitiesofthelesionsandnormaluterinecervixwereobservedandtheADCva-luesofthemweremeasured.Histologicalspecimenswerestainedwithhematoxylinanderosin.Thecellularitydensityofthirty-twouterinecervixcancerwascounted,whichwasregardedastheratioofthetotalareaoftumorcellnucleidividedbytheareaofsampleimage.ResultsAlltumorsofuterinecervixdemonstratehighsignalintensity,whereasthenormalcer-vixshowsnohighsignalintensity.ADCvalueisstatisticallydifferentbetweennormalandcanceroustissueintheuterinecervix,themeanADCvalueofcervicalcancerlesionsis(0.880.15)10-3mm2/s,andthatofnormalcervixtissueis(1.500.16)10-3mm2/s(P0.05).Inaddition,therearestatisticdifferencesbetweensquamouscarcinomaandad-enocarcinomaoftheuterinecervixaswel;lthemeanADCvalueoftheformeris(0.850.13)10-3mm2/s,andthela-tteroneis(0.980.22)10-3mm2/s.ThereisnegativecorrelationbetweenADCvalueofuterinecervixcancerandthecellularitydensity(r=-0.711,P=0.000),alsotheADCvalueofuterinecervixcancercorrelatesnegativelywiththegradingoftumor.ConclusionDWIhasapotentialabilitytodifferentiatebetweennormalandcanceroustissueintheu-terinecervix,anditcanindicatethepathologicaltypeofuterinecervixcanceraswel.lTheADCvalueofuterinecervixcancerrepresentstumorcellularitydensity,thusprovidinganewmethodforevaluatingthepathologicalgradingoftumor.KeywordsUterinecervixcancerDiffusionweightedimagingApparentdiffusioncoefficientvalueCellularityden-sity,2252009282,,[1],(DWI)11.120061020071242,25~80,47.234,8,MRI2006102007815,42~60,48.7,,,1.2MRIGE1.5TTwinSpeedInfinitywithExicite,Torsopa:(1):(FRFSE)T2WI,,TR4000ms,TE85ms,6mm,1mm,(NEX)2,(FOV)35cm/36cm,320224;T2WIT2WI(2)DWI:-(SE-EPI)DWI,TR4000ms,TE58.5ms,6mm,1mm,NEX4,FOV36cm,128128,b01000s/mm21.3AW4.0Functool2.0,DWI(ADC)3,(regionofinteres,tROI),100~200mm2,ROI,,ROI50mm2ADC1.44232HE,CMIAS,200,,5,1.5SPSSforWindows13.0tADCADCPearson,ADC;Spearman,ADC=0.05,P0.0522.1DWIADC42DWI,ADCADC(12),,(3)(2),ADCADCDWI,ADCADC(4)2.2ADC1,DWIb01000s/mm2,ADCADC,(P0.05)2.3ADC2,DWIb01000s/mm2,ADC,(P0.05)2.4ADC3,,1ADC(b=1000s/mm2)ADC(10-3mm2/s)tP42150.880.151.500.16-13.3330.0002ADC(b=1000s/mm2)ADC(10-3mm2/s)tP3480.850.130.980.22-2.1270.0403(%)ADC123720510.182.6216.151.4324.532.121.090.160.860.100.710.052262009282,Pearson,b01000s/mm2ADC(5),(r=-0.711,P=0.000)Spearman,ADC,(r=-0.778,P=0.000)33.1DWIDWI,,[2],ADCDWI[3]2090,MR,EPI,DWI[2]EPI,DWI3.2DWIDWI,,227200928242DWI,1DWI,ECTDWI,,,DWI,ADC[2]DWI,DWI,ADC[3~5],,ADCADC,,Naganawa[6]ADC,,ADC,ADC,,,,[7,8]Roth[7],,ADC;,ADCMatoba[9]DWI,,,ADC,ADC(P0.02)ADC(P0.05),,,,,,,ADC,ADC,ADCDWIMRI,,,T2WI,DWIMRIDWI,ADC[10],,ADC[11],,DWIADC,DWI[12],,,(intravoxelincoherentmotion,IVIM),[13],b,ADCIVIM();b,ADCIVIMb,,[13],,,,,3.3,,ADC;,ADCROI,1KaurH,SilvermanPM,IyerRB,eta.lDiagnosis,staging,andsur-veillanceofcervicalcarcinoma.AJR,2003,180:16212KohDM,CollinsDJ.Diffusion-weightedMRIinthebody:applica-tionsandchallengesinoncology.AJR,2007,188:16223TaouliB,VilgrainV,DumontE,eta.lEvaluationofliverdiffusion-isotropyandcharacterizationoffocalhepaticlesionswithtwosingle-shotecho-planarMRimagingsequences:prospectivestudyin66pa-tients.Radiology,2003,226:714ThoenyHC,DeKeyzerF,OyenRH,eta.lDiffusion-weightedMRimagingofkidneysinhealthyvolunteersandpatientswithparenchy-maldiseases:initialexperience.Radiology,2005,235:9115SatoC,NaganawaS,NakamuraT,eta.lDifferentiationofnoncancer-oustissueandcancerlesionsbyapparentdiffusioncoefficientvaluesintransitionandperipheralzonesoftheprostate.JMagnResonIma-2282009282ging,2005,21:2586NaganawaS,SatoC,KumadaH,eta.lApparentdiffusioncoefficientincervicalcanceroftheuterus:comparisonwiththenormaluterinecervix.EurRadio,l2005,15:717RothY,TichlerT,KostenichG,eta.lHigh-b-valuediffusion-weigh-tedMRimagingforpretreatmentpredictionandearlymonitoringoftumorresponsetotherapyinmice.Radiology,2004,232:6858,,,..,2006,10:3799MatobaM,TonamiH,KondouT,eta.lLungcarcinoma:diffusion-weightedMRimaging-preliminaryevaluationwithapparentdiffusioncoefficient.Radiology,2007,243:57010SumiM,VanCauterenM,NakamuraT.MRmicroimagingofbenignandmalignantnodesintheneck.AJR,2006,186:74911赟,梁碧玲,高立,等.颈部淋巴结的MR扩散加权成像.临床,2007,26:24412MurakamiR,SugaharaT,NakamuraH,eta.lMalignants