Diffusion-Weighted Magnetic Resonance Imaging of Uterine Cervical Cancer
Diffusion-Weighted Magnetic Resonance Imaging of Uterine Cervical Cancer
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DOI：
10.1097/rct.0b013e31819e93af
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发表时间：
2009-11-01
影响因子：
1.3
通讯作者：
Wang, Dehua
中科院分区：
文献类型：
--
作者：
Liu, Ying;Bai, Renju;Wang, Dehua
目的：探讨宫颈癌磁共振弥散加权成像(DWI)的可行性，探讨宫颈癌的表观扩散系数(ADC)值是否与正常宫颈不同，是否能反映肿瘤的组织学类型和病理分级。材料与方法：42例经手术病理证实的宫颈癌患者和15例子宫肌瘤患者，采用1.5T临床扫描仪(GE 1.5T Twin-SpeedInfinity配Excite II扫描仪；GE Healthcare，Waukeha，Waukeha)进行MR检查。扫描序列包括T2加权快速自旋回波成像、T2加权快速自旋回波脂肪抑制成像、T1加权自旋回波成像和扩散系数分别为0和1000 S/mm的弥散加权成像(2)。评价的参数包括宫颈癌和正常宫颈的ADC值。组织标本行苏木精-伊红染色。计算32例宫颈癌的细胞密度，取肿瘤细胞核总面积除以样本图像面积的比值。结果：宫颈正常组织与癌组织的表观扩散系数值有统计学差异(P=0.000)；前者为(平均[SD]，1.5[0.16])×10(-3)mm(2)/S，后者为(0.88[0.15])×10(-3)mm(2)/S，鳞癌的表观弥散系数值显著低于腺癌(P=0.040)。宫颈癌的ADC值与细胞密度呈负相关(r=-0.711，P=0.000)，与肿瘤分级呈负相关(r=-0.778，P=0.000)。结论：磁共振扩散加权成像具有鉴别宫颈正常组织和癌组织的潜力，并可提示宫颈癌的组织学类型。宫颈癌的ADC值代表肿瘤细胞密度，为评价肿瘤的病理分级提供了一种新的方法。
Purpose: To determine the feasibility of diffusion-weighted magnetic resonance (MR) imaging (DWI) of uterine cervical cancer and to investigate whether the apparent diffusion coefficient (ADC) values of cervical cancer differ from those of normal cervix and whether they could indicate the histologic type and the pathologic grade of tumor.Materials and Methods: Forty-two female patients with histopathologically proven uterine cervical cancer and 15 female patients with uterine leiomyomas underwent preoperative MR examinations using a 1.5-T clinical scanner (GE 1.5T Twin-Speed Infinity with Excite II scanner; GE Healthcare, Waukesha, Wis). Scanning sequences included T2-weighted fast spin-echo imaging, T2-weighted fast spin-echo with fat suppression imaging, T1-weighted spin-echo imaging, and DWI with diffusion factors of 0 and 1000 s/mm(2). Parameters evaluated consisted of ADC values of uterine cervical cancer and normal cervix. Histologic specimens were stained with hematoxylin and eosin. The cellular densities of 32 uterine cervical cancers were calculated, which were regarded as the ratio of the total area of tumor cell nuclei divided by the area of sample image.Results: Apparent diffusion coefficient value was statistically different (P = 0.000) between normal and cancerous tissue in the uterine cervix; the former one was (mean [SD], 1.50 [0.16]) x 10(-3) mm(2)/s, and the latter one was (0.88 [0.15]) x 10(-3) mm(2)/s. Apparent diffusion coefficient value of squamous carcinoma was statistically lower than that of adenocarcinoma (P = 0.040). The ADC value of uterine cervical cancer correlated negatively with cellular density (r = -0.711, P = 0.000) and the grading of tumor (r = -0.778, P = 0.000).Conclusions: Diffusion-weighted MR imaging has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix, and it call indicate the histologic type of uterine cervical cancer as well. The ADC value of uterine cervical cancer represents tumor cellular density, thus providing a new method for evaluating the pathologlic grading of tumor.