弥散加权成像在宫颈癌组织病理学研究中的价值

摘要

目的 探讨磁共振弥散加权成像(DWI)的表观弥散系数(ADC)值辨别子宫颈癌病理类型和分化程度的价值.方法 对68例治疗前的宫颈癌患者行磁共振DWI检查,测量病灶区ADC值.根据病理结果分为宫颈鳞状细胞癌(53例)、腺癌(15例),宫颈鳞状细胞癌分为高分化组(14例)、中分化组(28例)、低分化组(26例).比较不同病理类型宫颈癌和不同分化程度宫颈鳞状细胞癌的ADC值差异.结果 宫颈鳞状细胞癌和腺癌的ADC值分别为(0.899±0.117)×10-3mm2/s和(1.075±0.324)×10-3mm2/s,差异有统计学意义(t=-0.257,P=0.000＜ 0.05).以ADC值0.944×10-3mm2/s为阈值,鉴别宫颈鳞状细胞癌和腺癌的敏感性为100％,特异性为87.5％.ADC值与宫颈鳞状细胞癌高中低分化程度呈负相关(r=-0.67,P=0.000 ＜0.05).结论 DWI定量参数ADC值有助于评估宫颈癌的病理类型及分化程度,是常规MRI的重要补充.%Objective To investigate the value of diffusion weighted imaging (DWI) and the apparent diffusion coefficient (ADC) value for differentiating the pathologic categories and different differentiation of squamous cancer.Methods Sixty-eight patients with cervical cancer confirmed by histology underwent DWI at MRI before therapy.ADC values were measured.All cases were divided into squamous carcinoma group (53 cases) and adenocarcinoma group (15 cases).Fifty-three squamous carcinoma patients were grouped into highly differentiated group (14 cases),moderately differentiated group (28 cases),poorly differentiated group (26 cases).The ADC values in different pathologic categories of cervical cancer,and different differentiation of sqnamous cancer were also compared.Results There were significant differences between squamous carcinoma [(0.899 ± 0.117) ×10-3 mm2/s] and adenocarcinoma [(1.075 ± 0.324) × 10-3 mm2/s] of the cervix cancer (t =-0.257,P =0.000 ＜ 0.05).When ADC value was 0.944 × 10-3 mm2/s,the sensitivity and specificity were 100％,87.5％ in differentiating squamous carci noma and adenocarcinoma.There was negative correlation between ADC Value of uterine cervix cancer and the grades of tumor (r =-0.67,P =0.000 ＜ 0.05).Conclusion DWI is an important supplement for conventional MRI examination,which can help to differentiate pathological and grade.