摘要
目的探讨ADC值及DCE-MRI血流灌注定量参数对宫颈癌宫旁浸润的诊断价值,提高MRI诊断宫颈癌宫旁浸润之间诊断的准确性。方法选取我院手术确诊宫颈癌患者35例,根据病理结果分为宫旁浸润组(13例)和无宫旁浸润组(22例)。所有患者术前均行常规MRI检查、DWI和动态增强MRI扫描,测量ADC值,DCE-MRI血流灌注定量参数分析采用Omni Kinetics软件(GE,Healthcare),获得感兴趣区的定量参数包括容积转运常数Ktrans,速率常数Kep,血管外细胞外间隙容积比Ve,利用MRI形态学、ADC值及动态增强定量参数对于宫旁浸润进行诊断,对比其敏感度和特异度,绘制ROC曲线比较各参数的诊断效能,并采用Spearman法分析ADC值和各定量参数间的相关性。结果采用独立样本t检验比较各组间差异,宫旁浸润组Ktrans、Kep、Ve值均显著高于非宫旁浸润组(P<0.01)。诊断敏感度、特异度分别为76.9%、100%,84.6%、90.1%,92.3%、69.2%;ROC曲线下面积(AUC)分别为91.6%、86.4%、81.1%。宫旁浸润组ADC值显著低于无宫旁浸润组(P<0.01);ROC曲线下面积(AUC)为91.3%。Ktrans、Kep、Ve与ADC值呈负相关(r=-0.678,P<0.01;r=-0.449,P<0.01;r=-0.372,P<0.05)。结论ADC值及各定量参数Ktrans、Kep、Ve能提高对宫颈癌宫旁浸润术前诊断的敏感度及特异度,其中Ktrans及ADC值的诊断效能较高(91.6%,91.3%),对临床制定合理治疗方案有重要意义。
Objective To study the diagnostic value of ADC and DCE-MRI blood flow perfusion quantitative parameters for parametrial invasion of cervical cancer,and to improve the accuracy in the diagnosis of cervical cancer for parametrial invasion.Methods We collected 35 cases of cervical cancer diagnosed in our hospital.According to the pathological results,they were divided into the parametrial invasion group(13 cases)and the non-parametrial invasion group(22 cases).All patients underwent routine MRI,diffusion-weighted imaging(DWI)and dynamic enhanced MRI.The value of ADC was measused.The quantitative parameter of DCE-MRI was analysed by Omni Kinetics software(GE,Healthcare)which includes Ktrans,Kep and Ve.All those parameters were used to diagnose parametrial invasion of cervical cancer,and their sensitivity and specificity were compared.ROC curve was drew to compare these parameters on the diagnosis effectiveness of cervical cancer and the correlation between ADC and quantitative parameters.Results The values of Ktrans,Kep and Ve in the parametrial invasion group were significantly higher than those in the non-parametrial invasion group(P<0.01).The sensitivity and specificity of diagnostic were 76.9%,100%;84.6%,90.1%;92.3%,69.2%.The AUC was 91.6%,86.4%,81.1%;the value of ADC in the parametrial invasion group was significantly lower than the non-parametrial invasion group(P<0.01);the AUC was 91.3%.The values of Ktrans,Kep,Ve were significantly negatiVely correlated with ADC(r=-0.678,P<0.01;r=-0.449,P<0.01;r=-0.372,P<0.05).Conclusion The ADC value and quantitative parameters such as Ktrans,Kep and Ve can improve the sensitivity and specificity to diagnose the cervical cancer for parametrial invasion.The diagnostic efficiency of Ktrans and ADC values are higher(97.7%,93.5%).They have great significance to select a reasonable treatment plan for clinical practice.
作者
许敏
何永胜
戚轩
杨宏楷
王梦雅
XU Min;HE Yongsheng;QI Xuan;YANG Hongkai;WANG Mengya(Department of Radiology, People's Hospital of Maanshan City, Maanshan 243000, China)
出处
《医学影像学杂志》
2022年第3期480-483,共4页
Journal of Medical Imaging
关键词
宫颈癌
宫旁浸润
磁共振成像
定量参数
表观扩散系数
Cervical cancer
Parametrial
Magnetic resonance imaging
Quantitative parameters
Apparent diffusion coefficient
