宫颈癌诊断中动态增强MRI半定量参数与磁共振扩散加权成像ADC值的相关性研究

摘要

目的：研究宫颈癌诊断中应用动态增强核磁共振成像（MRI）半定量参数与磁共振扩散加权成像（DWI）的扩散系数（ADC）之间的相关性，探讨 DWI 在宫颈癌诊断和放疗疗效监测方面的价值。方法对2010年1月至2016年1月收集整理的87例宫颈癌患者临床资料作回顾性分析。将入选宫颈癌患者作为观察组，并选取30例非宫颈癌患者作为对照组。其中观察组有24例选择了放化疗进行治疗。对所有患者术前术后以及放化疗前后进行 MRI 和 DWI ；计算宫颈癌病灶 MRI 半定量参数，包括最大相对增强率（MRE）、流入速率（WIR）、流出速率（WOR）及达峰时间（TTP），并记录 ADC 与两者的相关性。结果观察组的MRE 、WIR 高于对照组；而 TTP 低于对照组；观察组的 ADC 也高于对照组；差异均有统计学意义（P＜0．05）。放化疗后除半定量参数 WOR 外其他指标及 ADC 与放化疗前比较，差异均有统计学意义（P ＜0．05）。放化疗后 ADC 与 MRE 、WIR 均呈现负相关（r＝－0．31、－0．29，P＜0．05），与 TTP 呈现正相关（r＝0．58，P＜0．05）。而 WOR 与 ADC 未呈现出任何相关性。结论 ADC与宫颈癌 MRI 半定量参数存在一定的相关性。%Objective To study the correlation between magnetic resonance imaging (MRI) semi quantitative parameters and ap‐parent diffusion coefficient (ADC) values of diffusion weighted imaging (DWI) in diagnosis of cervical cancer .Methods Clinical data of 87 cases with cervical cancer selected from January 2010 to January 2016 in the hospital were retrospectively analyzed .And patients with cervical cancer were treated as observation group ,and 30 patients without cervical cancer were treated as control group .And 24 patients in the observation group received radiotherapy treatment .All patients received MRI and DWI before and af‐ter surgery as well as before and after radiotherapy and chemotherapy .MRI semi quantitative parameters were calculated ,including maximum relative enhancement ratio (MRE) ,flow rate (WIR) ,outflow rate (WOR) and time to peak (TTP) ,in addition ,the rela‐tionship between these indicators and ADC was analyzed .Results MRE and WIR as well as ADC of the observation group were significantly higher than that of the control group (P< 0 .05) .And the TTP of the observation group was significantly lower than that of the control group (P< 0 .05) .All the semi quantitative parameters after radiotherapy and chemotherapy were significantly lower than before (P< 0 .05) except WOR .In the observation group ,ADC after radiotherapy and chemotherapy was also signifi‐cantly lower than before (P< 0 .05) .MRE and WIR were negatively correlated with ADC (r= - 0 .31 and - 0 .29 ,P< 0 .05) ,while the two indicators were positively correlated with TTP (r= 0 .58 ,P< 0 .05) .WOR didn′t correlate with ADC .Conclusion There is a correlation between ADC and MRI semi quantitative parameters in cervical cancer .