磁共振扩散加权成像在宫颈癌诊断和新辅助化疗疗效预测中的应用价值*

    王樱花**黄晖 邹轶群

    (上高人民医院放射科 江西宜春 336499)

    摘 要目的：探讨磁共振扩散加权成像(DWI)在宫颈癌诊断和新辅助化疗(NACT)疗效预测中的应用价值。方法：选取2012年8月-2014年2月在我院就诊的宫颈癌患者64例和21例无明显宫颈病变的健康志愿者行常规MRI和DWI检查，比较病变宫颈癌和正常宫颈及不同分期宫颈组织的ADC值，并分析化疗前后宫颈癌组织的ADC值变化。结果：宫颈癌ADC值明显低于正常宫颈(P<0.05)；ADC值诊断宫颈癌的ROC曲线下面积(AUC)为0.847，95%可信区间为0.731～0.972；不同分期宫颈癌ADC值比较，差异具有统计学意义(P<0.05)；宫颈癌治疗后有效患者16例，无效患者6例，有效患者中，第2次化疗后的ADC值明显较第1次化疗和治疗前高(P<0.05)，第1次化疗后ADC值与治疗前比较，差异无显著性(P>0.05)，无效患者在治疗前、第1次及第2次化疗的ADC值间的差异无显著性(P>0.05)。结论：DWI可鉴别宫颈癌和正常宫颈，有助于宫颈癌的诊断和疗效的预测。

    关键词宫颈癌 磁共振扩散加权成像 表观扩散系数 疗效 预测

    *基金项目：2013年度江西省教育厅科技计划项目(项目编号：GJJ13682)

    Value of diffusion weighted magnetic resonance imaging in the diagnosis of cervical cancer and the monitoring of neoadjuvant chemotherapy efficacy*

    HUANG Yinghua**, HUANG Hui, ZUI Yiqun

    (Department of Radiology, the People's Hospital of Shanggao City, Jiangxi 336499, China )

    ABSTRACTObjective: To estimate the value of diffusion weighted magnetic resonance imaging (DWI) in the diagnosis of cervical cancer and the monitoring of neoadjuvant chemotherapy (NACT) efficacy. Methods: MRI and DWI were performed in 64 cases of patients with cervical cancer and 21 cases of healthy volunteers, and the ADC value of uterine cervix lesions and normal cervix and the different stages of cervical cancer were compared, and the ADC value of patients with different effect in different time points after treatment were compared. Results: The ADC was significantly lower in the patients with cervical cancer than in the volunteers. The area of ROC was 0.847, and 95% confidence interval was 0.731~0.972. There was a significant difference between the ADC of different stages of cervical cancer. In all patients with cervical cancer, 16 cases of patients were effective (CR+PR), and 6 cases nvalid (PD+SD), the ADC after the second chemotherapy was significantly higher than that after the first chemotherapy and before treatment in the effective group, and there were no significant differences in ADCs after the first chemotherapy and before treatment and no significant difference neither in ADCs after the first and second chemotherapy and before treatment. Conclusion: DWI can be used to distinguish cervical carcinoma from normal cervical, and can be helpful to the diagnosis of cervical cancer and the monitoring of NACT efficacy. ......