Liu Ying, Bai Renju, Sun Haoran, Liu Haidong, Wang Dehua
Department of Radiology, General Hospital of Tianjin Medical University, Tianjin, China.
J Comput Assist Tomogr. 2009 Nov-Dec;33(6):858-62. doi: 10.1097/RCT.0b013e31819e93af.
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.
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/mm2. 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.
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) mm2/s, and the latter one was (0.88 [0.15]) x 10(-3) mm2/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).
Diffusion-weighted MR imaging has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix, and it can 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 pathologic grading of tumor.
确定子宫颈癌扩散加权磁共振成像（DWI）的可行性，并研究子宫颈癌的表观扩散系数（ADC）值是否与正常宫颈不同，以及它们是否能提示肿瘤的组织学类型和病理分级。
42例经组织病理学证实的子宫颈癌女性患者和15例子宫肌瘤女性患者使用1.5-T临床扫描仪（GE 1.5T Twin-Speed Infinity with Excite II扫描仪；GE医疗集团，威斯康星州沃基沙）进行术前磁共振检查。扫描序列包括T2加权快速自旋回波成像、脂肪抑制的T2加权快速自旋回波成像、T1加权自旋回波成像以及扩散因子为0和1000 s/mm2的DWI。评估的参数包括子宫颈癌和正常宫颈的ADC值。组织学标本用苏木精和伊红染色。计算32例子宫颈癌的细胞密度，其被视为肿瘤细胞核总面积与样本图像面积之比。
子宫颈正常组织与癌组织之间的表观扩散系数值有统计学差异（P = 0.000）；前者为（均值[标准差]，1.50[0.16]）×10⁻³mm²/s，后者为（0.88[0.15]）×10⁻³mm²/s。鳞状细胞癌的表观扩散系数值在统计学上低于腺癌（P = 0.040）。子宫颈癌的ADC值与细胞密度（r = -0.711，P = 0.000）和肿瘤分级（r = -0.778，P = 0.000）呈负相关。
扩散加权磁共振成像有潜力区分子宫颈的正常组织和癌组织，并且它也能提示子宫颈癌的组织学类型。子宫颈癌的ADC值代表肿瘤细胞密度，从而为评估肿瘤的病理分级提供了一种新方法。
