中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
18期
3244-3248
,共5页
宫颈肿瘤%磁共振成像,弥散%表观弥散系数
宮頸腫瘤%磁共振成像,瀰散%錶觀瀰散繫數
궁경종류%자공진성상,미산%표관미산계수
Uterine cervical neoplasms%Diffusion megnetic resonance imaging%Apparent diffusion coefficient
目的：探讨3.0 T 磁共振弥散加权成像（DWI）在宫颈癌诊断中的应用价值，探讨宫颈癌表观弥散系数（ADC）值与临床病理之间的相关性。方法经妇科常规检查、超声等证实排除子宫颈病变者20例，经宫颈活检或手术病理证实的宫颈癌患者94例，所有病例均行常规 MRI及DWI扫描（b＝0、1000 s/mm2），分别测量正常子宫颈内膜ADC值、子宫颈癌ADC值。对所得数据进行统计分析。结果宫颈癌病例组病灶的平均ADC值为（0.8271±0.1486）×10-3 mm2/s，明显低于正常子宫颈内膜的平均ADC值[（1.5264±0.0687）×10-3 mm2/s]；应用ROC曲线分析得出宫颈癌最佳ADC诊断阈值为1.284×10-3 mm2/s，其灵敏度为100%，特异性为98.9%。宫颈鳞癌平均ADC值为（0.8054±0.1201）×10-3 mm2/s，宫颈腺癌平均ADC值为（0.9850±0.1661）×10-3 mm2/s，两者差异有统计学意义（P＜0.05）；宫颈鳞癌不同病理分级平均的ADC值：G1级（0.9494±0.0836）×10-3 mm2/s，G2级（0.8169±0.0994）×10-3 mm2/s，G3级（0.7067±0.0878）×10-3 mm2/s，两两之间差异均有统计学意义（均 P＜0.05）；ADC 值与病理分级之间呈显著负相关（r＝-0.616，P＝0.000）。结论 DWI有助于宫颈癌的诊断，并对宫颈癌的病理分型、分级有一定的辅助诊断作用。
目的：探討3.0 T 磁共振瀰散加權成像（DWI）在宮頸癌診斷中的應用價值，探討宮頸癌錶觀瀰散繫數（ADC）值與臨床病理之間的相關性。方法經婦科常規檢查、超聲等證實排除子宮頸病變者20例，經宮頸活檢或手術病理證實的宮頸癌患者94例，所有病例均行常規 MRI及DWI掃描（b＝0、1000 s/mm2），分彆測量正常子宮頸內膜ADC值、子宮頸癌ADC值。對所得數據進行統計分析。結果宮頸癌病例組病竈的平均ADC值為（0.8271±0.1486）×10-3 mm2/s，明顯低于正常子宮頸內膜的平均ADC值[（1.5264±0.0687）×10-3 mm2/s]；應用ROC麯線分析得齣宮頸癌最佳ADC診斷閾值為1.284×10-3 mm2/s，其靈敏度為100%，特異性為98.9%。宮頸鱗癌平均ADC值為（0.8054±0.1201）×10-3 mm2/s，宮頸腺癌平均ADC值為（0.9850±0.1661）×10-3 mm2/s，兩者差異有統計學意義（P＜0.05）；宮頸鱗癌不同病理分級平均的ADC值：G1級（0.9494±0.0836）×10-3 mm2/s，G2級（0.8169±0.0994）×10-3 mm2/s，G3級（0.7067±0.0878）×10-3 mm2/s，兩兩之間差異均有統計學意義（均 P＜0.05）；ADC 值與病理分級之間呈顯著負相關（r＝-0.616，P＝0.000）。結論 DWI有助于宮頸癌的診斷，併對宮頸癌的病理分型、分級有一定的輔助診斷作用。
목적：탐토3.0 T 자공진미산가권성상（DWI）재궁경암진단중적응용개치，탐토궁경암표관미산계수（ADC）치여림상병리지간적상관성。방법경부과상규검사、초성등증실배제자궁경병변자20례，경궁경활검혹수술병리증실적궁경암환자94례，소유병례균행상규 MRI급DWI소묘（b＝0、1000 s/mm2），분별측량정상자궁경내막ADC치、자궁경암ADC치。대소득수거진행통계분석。결과궁경암병례조병조적평균ADC치위（0.8271±0.1486）×10-3 mm2/s，명현저우정상자궁경내막적평균ADC치[（1.5264±0.0687）×10-3 mm2/s]；응용ROC곡선분석득출궁경암최가ADC진단역치위1.284×10-3 mm2/s，기령민도위100%，특이성위98.9%。궁경린암평균ADC치위（0.8054±0.1201）×10-3 mm2/s，궁경선암평균ADC치위（0.9850±0.1661）×10-3 mm2/s，량자차이유통계학의의（P＜0.05）；궁경린암불동병리분급평균적ADC치：G1급（0.9494±0.0836）×10-3 mm2/s，G2급（0.8169±0.0994）×10-3 mm2/s，G3급（0.7067±0.0878）×10-3 mm2/s，량량지간차이균유통계학의의（균 P＜0.05）；ADC 치여병리분급지간정현저부상관（r＝-0.616，P＝0.000）。결론 DWI유조우궁경암적진단，병대궁경암적병리분형、분급유일정적보조진단작용。
Objective To investigate the diagnostic value of 3.0 T diffusion weighted imaging(DWI) for uterine cervix cancer. This study was to assess the value of DWI in indicating the pathological type and pathological grading with cervical cancer. Methods Conventional and DWI (b=0, 1 000 s/mm2) were performed in 94 consecutive females with pathologically proven uterine cervix cancer and 20 females with normal uterine cervix. The ADC value of normal uterine cervix and cervix cancer were measured. Statistical analysis was performed on the date collected. Results The mean ADC value of cervix cancer [(0.827 1±0.148 6)×10-3 mm2/s] was significantly lower than normal uterine cervix [(1.526 4± 0.068 7)×10-3 mm2/s]. With ROC cut point setting to 1.284×10-3 mm2/s, the diagnostic sensitivity and specificity was 100%and 98.9%. The mean ADC value of squamous carcinoma [(0.805 4±0.120 1)× 10-3 mm2/s] was lower than that of adenocarcinoma [(0.985 0±0.166 1)×10-3 mm2/s]. And the mean ADC value for each pathological grade was G1 (0.949 4±0.083 6)×10-3 mm2/s, G2 (0.816 9±0.099 4)×10-3 mm2/s, G3 (0.706 7±0.087 8)×10-3 mm2/s, and there was statistically significant difference between different pathological grades. The ADC value of uterine cervix cancer correlates negatively with the grading of tumor. Conclusion DWI has a potential ability to differentiate between cervix cancer and normal uterine cervix, and it can indicate the pathological type of uterine cervix and provide a new method for evaluating the pathological grading of tumor.
