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目的探讨磁共振弥散加权成像(DWI)结合动态增强扫描在子宫颈癌分期中的诊断价值。方法回顾性分析2013年11月~2014年8月广州医科大学附属第四医院56例经病理证实的宫颈癌患者的DWI及动态增强扫描结果,测量病灶表观扩散系数(ADC)值判断浸润范围,并与手术病理结果进行比较。结果宫颈癌在DWI图像上表现为高信号,ADC值降低,平均ADC值为(0.92±0.16)×10-3mm2/s。动态增强扫描早期病灶明显快速强化,延迟期病灶中心呈低信号,病灶边缘呈稍高信号,与邻近正常宫颈组织信号明显不同,形成对比。DWI结合动态增强扫描对宫颈癌FIGO分期(2009)总准确性为93.75%,高于常规MRI分期总准确性(81.25%),对宫旁浸润评估的准确性为100.00%。结论 DWI结合动态增强扫描磁共振检查能提高宫颈癌侵犯程度评价的准确性,对宫颈癌的诊断、临床分期及制订正确的治疗方案具有重要意义。
Objective To investigate the diagnostic value of diffusion weighted imaging (DWI) combined with dynamic contrast-enhanced scanning in the staging of cervical cancer. Methods The DWI and dynamic contrast-enhanced scanning of 56 pathologically confirmed cervical cancer patients from the Fourth Affiliated Hospital of Guangzhou Medical University from November 2013 to August 2014 were retrospectively analyzed. The apparent diffusion coefficient (ADC) value of the lesions was measured to determine the extent of infiltration , And compared with the surgical pathology results. Results Cervical cancer showed high signal intensity on DWI images and ADC value decreased with an average ADC value of (0.92 ± 0.16) × 10-3mm2 / s. Dynamic contrast-enhanced early lesion was rapidly and rapidly enhanced. The lesion showed a low signal in the center of the lesion and a slightly higher signal at the edge of the lesion, which was significantly different from that of the adjacent normal cervical tissue. The overall accuracy of DWI combined with dynamic contrast-enhanced scan (FIGO stage 2009 (2009)) was 93.75%, higher than that of conventional MRI (81.25%) and 100.00% for parametrial invasion. Conclusion DWI combined with dynamic contrast-enhanced magnetic resonance imaging (MRI) can improve the accuracy of evaluation of cervical cancer invasion. It is of great significance for diagnosis, clinical staging and proper treatment of cervical cancer.