DWI对宫颈癌诊断及其分期、盆腔淋巴结转移检出率的研究
|
摘要
目的分析磁共振扩散加权成像(DWI)对宫颈癌诊断及其分期、盆腔淋巴结转移检出率的价值。方法对山东省医学科学院附属医院2016年1月至2018年1月确诊宫颈癌55例患者临床资料进行分析,比较磁共振成像(MRI)和DWI诊断宫颈癌的价值。结果 MRI平扫与MRI平扫联合DWI对宫颈癌诊断价值无显著性差异(χ~2值分别为1.803、0.309、0.712、0.826,均P>0.05),MRI增强扫描联合DWI诊断宫颈癌的灵敏度、特异度、阳性预测值均显著高于MRI平扫(χ~2值分别为3.736、3.791、3.939,均P<0.05),MRI平扫联合DWI与MRI增强扫描联合DWI对宫颈癌诊断价值无显著性差异(χ~2值分别为0.358、1.640、1.448、0.528,均P>0.05)。不同检查方法对于宫颈癌不同分期诊断符合率虽无显著性差异(χ~2值分别为4.145、4.482、3.741,均P>0.05),但MRI平扫符合率最低,MRI增强扫描联合DWI符合率最高。MRI平扫检出转移淋巴结57个(68.67%),MRI平扫联合DWI检出转移淋巴结62个(74.70%),MRI增强扫描联合DWI检出转移淋巴结77个(92.77%),3种检查方法对于转移淋巴结检出率有显著性差异(χ~2=15.580,P=0.000)。结论 DWI对宫颈癌诊断及其分期、盆腔淋巴结转移检出率有很大的诊断价值,尤其适合于早期患者,值得临床推广应用。
Objective To study the value of diffusion weighted imaging(DWI)in diagnosis and staging of cervical cancer and detection rate of pelvic lymph node metastasis.Methods Clinical data of 55 patients diagnosed with cervical cancer in Affiliated Hospital of Shandong Academy of Medical Sciences from January 2016 to January 2018 were analyzed.Diagnostic values of magnetic resonance imaging(MRI)and DWI were compared.Results There was no significant difference in diagnostic value of cervical cancer between MRI plain scan and MRI plain scan combined with DWI(χ~2 value was 1.803,0.309,0.712 and 0.826,respectively,all P >0.05).Sensitivity,specificity and positive predictive value of MRI enhanced scan combined with DWI in detection of cervical cancer were significantly higher than those ofof MRI plain scan(χ~2 value was 3.736,3.791 and 3.939,respectively,all P<0.05).There was no significant difference in diagnostic value of cervical cancer between MRI plain scan combined with DWI and enhanced MRI combined with DWI(χ~2 value was 0.358,1.640,1.448 and 0.528,respectively,all P>0.05).Though there was no significant difference in diagnostic coincidence rate of different stages of cervical cancer among different screening methods(χ~2 value was 4.145,4.482 and 3.741,respectively,all P>0.05),diagnostic coincidence rate of MRI plain scan was lowest and MRI enhanced scan combined with DWI was highest.Number of metastasis lymph nodes detected by MRI plain scan was 57(68.67%),62(74.70%)by MRI plain scan combined with DWI,and 77(92.77%)by enhanced MRI combined with DWI.There was significant difference in detection rate of metastatic lymph node among three detecting methods(χ~2=15.580,P=0.000).Conclusion DWI has great diagnostic value for cervical cancer diagnosis,staging and pelvic lymph node metastasis detection.It is especially suitable for patients at early stage and worthy of clinical application.
Objective To study the value of diffusion weighted imaging(DWI)in diagnosis and staging of cervical cancer and detection rate of pelvic lymph node metastasis.Methods Clinical data of 55 patients diagnosed with cervical cancer in Affiliated Hospital of Shandong Academy of Medical Sciences from January 2016 to January 2018 were analyzed.Diagnostic values of magnetic resonance imaging(MRI)and DWI were compared.Results There was no significant difference in diagnostic value of cervical cancer between MRI plain scan and MRI plain scan combined with DWI(χ~2 value was 1.803,0.309,0.712 and 0.826,respectively,all P >0.05).Sensitivity,specificity and positive predictive value of MRI enhanced scan combined with DWI in detection of cervical cancer were significantly higher than those ofof MRI plain scan(χ~2 value was 3.736,3.791 and 3.939,respectively,all P<0.05).There was no significant difference in diagnostic value of cervical cancer between MRI plain scan combined with DWI and enhanced MRI combined with DWI(χ~2 value was 0.358,1.640,1.448 and 0.528,respectively,all P>0.05).Though there was no significant difference in diagnostic coincidence rate of different stages of cervical cancer among different screening methods(χ~2 value was 4.145,4.482 and 3.741,respectively,all P>0.05),diagnostic coincidence rate of MRI plain scan was lowest and MRI enhanced scan combined with DWI was highest.Number of metastasis lymph nodes detected by MRI plain scan was 57(68.67%),62(74.70%)by MRI plain scan combined with DWI,and 77(92.77%)by enhanced MRI combined with DWI.There was significant difference in detection rate of metastatic lymph node among three detecting methods(χ~2=15.580,P=0.000).Conclusion DWI has great diagnostic value for cervical cancer diagnosis,staging and pelvic lymph node metastasis detection.It is especially suitable for patients at early stage and worthy of clinical application.
引文
[1]Zhou Y,Liu J,Liu C,et al.Intravoxel incoherent motion diffusion weighted MRI of cervical cancer-Correlated with tumor differentiation and perfusion[J]Magn Reson Imaging,2016,34(8):1050-1056.
[2]He X Q,Wei L N.Diagnostic value of lymph node metastasis by diffusion-weighted magnetic resonance imaging in cervical cancer[J].J Cancer Res Ther,2016,12(1):77-83.
[3]Wang Y C,Hu D Y,Hu X M,et al.Assessing the early response of advanced cervical cancer to neoadjuvant chemotherapy using intravoxel incoherent motion diffusion-weighted magnetic resonance imaging:apilot study[J].Chin Med J(Engl),2016,129(6):665-671.
[4]林仲秋.《FIGO2015妇癌报告》解读连载——宫颈癌诊治指南解读[J].中国实用妇科与产科杂志,2015,31(11):981-985.
[5]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志(电子版),2015,11(2):1-6.
[6]杜欣欣,赛晓勇,刘爱军,等.宫颈癌筛查系统在宫颈癌筛查中的诊断价值[J].中华医学杂志,2015,95(29):2379-2381.
[7]张海燕,宋迪.多层螺旋CT与MRI对宫颈癌术前分期的诊断价值比较[J].中国妇幼健康研究,2014,25(1):111-113.
[8]Gladwish A,Milosevic M,Fyles A,et al.Association of apparent diffusion coefficient with disease recurrence in patients with locally advanced cervical cancer treated with radical chemotherapy and radiation therapy[J].Radiology,2016,279(1):158-166.
[9]刘鲁,范晓黎,朱晓玲,等.磁共振扩散加权成像参数与宫颈癌组织学特点的相关性[J].现代肿瘤医学,2017,25(12):1987-1991.
[2]He X Q,Wei L N.Diagnostic value of lymph node metastasis by diffusion-weighted magnetic resonance imaging in cervical cancer[J].J Cancer Res Ther,2016,12(1):77-83.
[3]Wang Y C,Hu D Y,Hu X M,et al.Assessing the early response of advanced cervical cancer to neoadjuvant chemotherapy using intravoxel incoherent motion diffusion-weighted magnetic resonance imaging:apilot study[J].Chin Med J(Engl),2016,129(6):665-671.
[4]林仲秋.《FIGO2015妇癌报告》解读连载——宫颈癌诊治指南解读[J].中国实用妇科与产科杂志,2015,31(11):981-985.
[5]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志(电子版),2015,11(2):1-6.
[6]杜欣欣,赛晓勇,刘爱军,等.宫颈癌筛查系统在宫颈癌筛查中的诊断价值[J].中华医学杂志,2015,95(29):2379-2381.
[7]张海燕,宋迪.多层螺旋CT与MRI对宫颈癌术前分期的诊断价值比较[J].中国妇幼健康研究,2014,25(1):111-113.
[8]Gladwish A,Milosevic M,Fyles A,et al.Association of apparent diffusion coefficient with disease recurrence in patients with locally advanced cervical cancer treated with radical chemotherapy and radiation therapy[J].Radiology,2016,279(1):158-166.
[9]刘鲁,范晓黎,朱晓玲,等.磁共振扩散加权成像参数与宫颈癌组织学特点的相关性[J].现代肿瘤医学,2017,25(12):1987-1991.