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目的探讨扩散加权成像(DWI)在宫颈癌的新辅助化疗疗效中的评价作用。方法收集我院经病理检查证实的25例宫颈癌患者,在新辅助化疗前及化疗后行常规MRI及DWI检查,评价化疗前后肿瘤及转移性淋巴结在DWI图像及其ADC值的变化。结果 (1)25例宫颈癌化疗后肿瘤实性成分ADC值较化疗前明显升高,且肿块体积的变化差异有统计学意义(P<0.01)。(2)DWI序列对转移性淋巴结的检出敏感性高于T2WT序列,差异有统计学意义(P<0.05)。化疗有效的淋巴结DWI信号减低,ADC值增高。(3)宫颈癌病理分型平均ADC值差异有统计学意义(P<0.05)。结论 DWI序列评价宫颈癌化疗前后疗效早于肿瘤体积变化,检测转移性淋巴结的敏感性高于常规MRI。
Objective To evaluate the evaluation of diffusion-weighted imaging (DWI) in neoadjuvant chemotherapy for cervical cancer. Methods Twenty-five patients with cervical cancer confirmed by pathology were collected and examined by conventional MRI and DWI before and after neoadjuvant chemotherapy to evaluate the changes of DWI images and ADC values of tumor and metastatic lymph nodes before and after chemotherapy. Results (1) The ADC value of 25 cervical cancer patients after chemotherapy was significantly higher than that before chemotherapy, and the difference of tumor volume was statistically significant (P <0.01). (2) The detection sensitivity of DWI sequence in metastatic lymph nodes is higher than that in T2WT sequences, the difference is statistically significant (P <0.05). Chemotherapy effective lymph node DWI signal reduction, ADC value increased. (3) The average ADC value of cervical cancer pathological classification was statistically significant (P <0.05). Conclusion The DWI evaluation of cervical cancer before and after chemotherapy is earlier than the change of tumor volume, and the sensitivity of detecting metastatic lymph nodes is higher than that of conventional MRI.