摘要
目的探讨磁共振多b值弥散加权成像(MR-DWI)对早期宫颈癌的诊断价值。方法选取2017年10月至2020年10月间眉县中医医院收治的150例早期宫颈癌患者,以病理检查为金标准,对所有患者进行MR-DWI检查,判断MR-DWI对早期宫颈癌的诊断价值。结果患者中IB1期95例,IB2期26例,ⅡA1期15例,ⅡA2期11例,其中漏诊1例,诊断为Ⅳ期2例,病理诊断早期宫颈癌准确率为98.7%。MR-DWI诊断准确率为92.7%,其中漏诊2例,诊断为Ⅳ期和Ⅲ期7例。两种诊断准确率比较,差异无统计学意义(P>0.05)。肿瘤半径>1cm患者与肿瘤半径≤1cm患者的F_(fast)、ADCf ast和ADCs_(low)参数比较,差异无统计学意义(P>0.05)。鳞癌患者ADCs_(low)数值低于腺癌患者,ADCf ast和F_(fast)参数高于腺癌患者,差异均有统计学意义(均P<0.05)。淋巴结转移和无淋巴结转移患者F_(fast)、ADCf ast和ADCs_(low)参数比较,差异均有统计学意义(均P<0.05)。结论MR-DWI能提升早期宫颈癌患者的诊断准确率,且对于腺癌和鳞癌具有一定鉴别作用,能准确检测淋巴结转移情况,可为患者的临床诊断与治疗提供一定参考。
Objective To investigate the diagnostic value of magnetic resonance and multi-b-value diffusion weighted imaging(MR-DWI)for early cervical cancer.Methods A total of 150 patients with early cervical cancer admitted to Mei County Hospital of Traditional Chinese Medicine were selected from October 2017 to October 2020.All patients were examined by multi-b-value diffusion-weighted imaging with pathological examination as the gold standard so as to judge the diagnostic value of multi-b-value diffusion-weighted imaging for early-stage cervical cancer.Results Among them,95 patients were diagnosed with stageⅠB1 cervical cancer,26 patients were diagnosed with stageⅠB2 cervical cancer,15 patients were diagnosed with stageⅡA1 cervical cancer,11 patients were diagnosed with stageⅡA2 cervical cancer with 1 patient missed diagnosis and 2 patients diagnosed as stageⅣ.The diagnostic accuracy rate was 98.7%for pathological diagnosis and 92.7%multi-b-value diffusion weighted imaging for early cervical cancer with 2 patients missed diagnosis and 7 patients diagnosed as stageⅣorⅢ.There was no significant difference in diagnostic accuracy rate between the two diagnostic methods(P>0.05).There was no significant differ-ence in the parameters of F_(fast),apparent diffusion coefficient(ADC)f ast and ADCs_(low) between patients with tumor semidiameter>1 cm and patients with tumor semidiameter≤1 cm(P>0.05).ADCs_(low) was lower and ADCf ast and F_(fast) were higher in patients with squamous cell carcinoma than in patients with adenocarcino-ma(all P<0.05).There was significant difference in the parameters of F_(fast),ADCf ast and ADCs_(low) between patients with lymph node metastasis and patients without lymph node metastasis(all P<0.05).Conclu-sion Magnetic resonance and multi-b-value diffusion-weighted imaging can improve the diagnostic accuracy for early cervical cancer with a certain differential diagnosis for adenocarcinoma and squamous cell carci-noma,and it can accurately detect lymph node metastasis and can provide certain reference for clinical diag-nosis and treatment of cervical cancer.
作者
王康
权晓华
WANG Kang;QUAN Xiao-hua(Department of Medical Imaging,Mei County Hospital of Traditional Chinese Medicine,Baoji 722300,China;Department of Medical Imaging,Xi'an Medical University Affiliated Baoji Hospital,Baoji 721006,China)
出处
《中国肿瘤临床与康复》
2021年第10期1196-1199,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
宫颈肿瘤
磁共振
b值弥散加权成像
临床分期
病理分型
Cervical neoplasms
Magnetic resonance imaging
B-value diffusion weighted im-aging
Clinical stage
Pathological classification
