弥散加权和动态对比增强磁共振在预测局灶性宫颈间质环破坏的 IB 期至 IIA 期宫颈癌宫旁侵犯中的价值。
Value of diffusion-weighted and dynamic contrast-enhanced MR in predicting parametrial invasion in cervical stromal ring focally disrupted stage IB-IIA cervical cancers.
机构信息
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210029, China.
Department of Obstetrics & Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
出版信息
Abdom Radiol (NY). 2019 Sep;44(9):3166-3174. doi: 10.1007/s00261-019-02107-y.
OBJECTIVES
To compare the effectiveness of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) imaging in detecting parametrial invasion (PMI) in cervical stromal ring focally disrupted stage IB-IIA cervical cancers.
METHODS
Eighty-one patients with cervical stromal ring focally disrupted stage IB-IIA cervical cancers (PMI positive, n = 35; PMI negative, n = 46) who underwent preoperative MRI and radical hysterectomy were included in this study. Preoperative clinical variables and MRI variables were analyzed and compared.
RESULTS
The K (min, mean, 10%, 25%, 50%, 75%, 90%), K (min, 10%, 25%, 50%, 75%, 90%), and V (min, 10%, 25%, 50%, 75%, 90%) values of patients with PMI were significantly higher than patients without PMI. The apparent diffusion coefficient (ADC) value did not show statistical difference between the two groups (1.01 ± 0.21 vs. 0.97 ± 0.20 10 mm/s, p = 0.360). Tumor craniocaudal planes were higher in PMI-positive group than PMI-negative group (35.84 ± 15.39 vs. 29.70 ± 11.78 mm, p = 0.048). Tumor craniocaudal planes combined with K value showed the highest area under the curve (AUCs) of 0.775, with a sensitivity of 72.7% and a specificity of 71.1% (p = 0.000).
CONCLUSIONS
DCE parameters combined tumor craniocaudal planes may represent a prognostic indicator for PMI in cervical stromal ring focally disrupted IB-IIA cervical cancers.
目的
比较弥散加权成像（DWI）和动态对比增强（DCE）成像在检测宫颈间质环局灶性中断的 IB-IIA 期宫颈癌中宫旁侵犯（PMI）的有效性。
方法
本研究纳入了 81 例宫颈间质环局灶性中断的 IB-IIA 期宫颈癌患者（PMI 阳性，n=35；PMI 阴性，n=46），这些患者均接受了术前 MRI 和根治性子宫切除术。分析并比较了术前临床变量和 MRI 变量。
结果
PMI 患者的 K（最小、平均、10%、25%、50%、75%、90%）、K（最小、10%、25%、50%、75%、90%）和 V（最小、10%、25%、50%、75%、90%）值明显高于无 PMI 患者。两组间的表观扩散系数（ADC）值无统计学差异（1.01±0.21 比 0.97±0.20 10 mm/s，p=0.360）。PMI 阳性组的肿瘤头尾平面高于 PMI 阴性组（35.84±15.39 比 29.70±11.78 mm，p=0.048）。肿瘤头尾平面联合 K 值的曲线下面积（AUC）最高，为 0.775，灵敏度为 72.7%，特异性为 71.1%（p=0.000）。
结论
DCE 参数联合肿瘤头尾平面可能是宫颈间质环局灶性中断的 IB-IIA 期宫颈癌中 PMI 的预后指标。
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