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目的探讨背景抑制弥散成像(diffusionweightedimagingwithbackgroundsuppression,DWIBS)技术在宫颈癌及转移淋巴结成像的应用。方法对2007年1月至2008年7月哈尔滨医科大学附属肿瘤医院160例宫颈癌患者术前行常规MRI及DWIBS检查,分别测量肿瘤实质、转移淋巴结及正常宫颈实质的表观弥散系数值(ADC值)。行3D最大密度投影(MIP)重组及黑白翻转技术观察瘤体与淋巴结的信号特点,以术后病理诊断为金标准,采用病例自身对照法将临床及影像学进行对比,评价DWIBS在宫颈癌及其转移淋巴结的表现作用。结果DWIBS瘤灶显示率96.88%,淋巴结显示率90.90%。瘤灶与肿大淋巴结呈高信号,反转图呈低信号。结论DWIBS可以通过ADC值对宫颈癌及转移淋巴结量化,并能直观地、立体地、多角度观察淋巴结的分布,从而可在术前更好的评估患者淋巴结转移情况,指导手术治疗。
Objective To investigate the application of diffusion weighted imaging (DWIPS) in cervical cancer and metastatic lymph node imaging. Methods From January 2007 to July 2008, 160 patients with cervical cancer at Affiliated Tumor Hospital of Harbin Medical University underwent routine MRI and DWIBS before operation. Apparent diffusion coefficient (ADC) of tumor parenchyma, metastatic lymph node and normal cervical mass were measured respectively value). The lines of tumor and lymph node were observed by MIP reconstruction and black-and-white reversal technique. The pathological diagnosis was taken as the gold standard after surgery. The clinical and imaging studies were compared with the case-control study to evaluate the effect of DWIBS on cervical cancer and Its lymph node metastasis performance. Results DWIBS tumor showed a rate of 96.88%, lymph node showed rate of 90.90%. Tumor and enlarged lymph nodes were high signal, inverted map showed low signal. Conclusion DWIBS can quantify cervical cancer and metastatic lymph nodes by ADC value, and can observe the distribution of lymph nodes intuitively, stereoscopically and multi-angles so as to better evaluate the lymph node metastasis and guide surgical treatment before operation.