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目的探讨表观扩散系数(ADC)值在宫颈癌评估中的潜在价值。方法共112例宫颈癌病人及67例正常对照者在治疗前行常规3.0TMR成像及扩散加权成像(DWI)。所有ADC值分别用b=0,600s/mm2和b=0,1000s/mm2进行计算。结果两组ADC图均显示子宫颈癌的ADC值显著低于正常宫颈。高/中分化(G1/2)和低分化(G3)肿瘤的ADC值之间、鳞状细胞癌和腺癌的ADC值之间、根治性子宫切除术后复发或转移和术后无瘤生存者的术前ADC之间差异均有统计学意义。当子宫颈癌按其他特征(FIGO、淋巴结是否转移、肿瘤大小和年龄段)进行分组时,两组ADC图差异均无统计学意义。结论 ADC值在子宫颈癌和正常宫颈的鉴别诊断中有很高的诊断准确率。尽管存在一些重叠,ADC值仍可预示宫颈癌的组织学类型和分级。G3级肿瘤和较低的ADC值预示预后较差。两组ADC图的诊断准确性相同。要点①DWI为子宫颈癌提供了新的信息。②ADC值可以鉴别宫颈癌和正常宫颈。③治疗前ADC值可以预测根治性子宫切除术病人的预后。④ADC值有助于预示子宫颈癌的组织学类型和分级。⑤G3级肿瘤和较低ADC值病人可以从术前放化疗中受益。
Objective To investigate the potential value of Apparent Diffusion Coefficients (ADC) in the assessment of cervical cancer. METHODS: A total of 112 cervical cancer patients and 67 normal controls were treated with conventional 3.0T MR imaging and diffusion-weighted imaging (DWI) before treatment. All ADC values are calculated with b = 0,600 s / mm2 and b = 0,1000 s / mm2, respectively. Results ADC images of both groups showed that the ADC value of cervical cancer was significantly lower than that of normal cervix. ADC values for high / moderately differentiated (G1 / 2) and poorly differentiated (G3) tumors, between ADC values for squamous cell carcinomas and adenocarcinomas, recurrence or metastasis after radical hysterectomy, and postoperative tumor-free survival The difference between preoperative ADC was statistically significant. When cervical cancer was grouped according to other characteristics (FIGO, lymph node metastasis, tumor size and age), there was no significant difference in ADC patterns between the two groups. Conclusion The ADC value has a high diagnostic accuracy in the differential diagnosis of cervical cancer and normal cervix. Although there is some overlap, ADC values can still predict the histological type and grade of cervical cancer. G3 tumors and lower ADC values indicate poor prognosis. The diagnostic accuracy of the two ADC maps is the same. Points ①DWI provides new information for cervical cancer. ② ADC value can identify cervical cancer and normal cervix. ③ ADC value before treatment can predict the prognosis of radical hysterectomy patients. ④ ADC value helps predict the histological type and grade of cervical cancer. ⑤G3 grade tumors and patients with lower ADC value can benefit from preoperative chemoradiation.