Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Gynecology and Obstetrics, Huaihe Hospital of Henan University, Kaifeng, China.
Br J Radiol. 2023 Aug;96(1148):20220952. doi: 10.1259/bjr.20220952. Epub 2023 May 15.
To evaluate the clinical feasibility of T1 mapping and multimodel diffusion-weighted imaging (DWI) for assessing the histological type, grade, and lymphovascular space invasion (LVSI) of cervical cancer.
Eighty patients with cervical cancer and 43 patients with a normal cervix underwent T1 mapping and DWI with 11 b-values (0-2000 s/mm). Monoexponential, biexponential, and kurtosis models were fitted to calculate the apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction (f), mean diffusivity (MD), and mean kurtosis (MK). Native T1 and DWI-derived parameters (ADC, ADC, D, D, D*, f, MD, MD, MK, and MK) were compared based on histological type, grade, and LVSI status.
Native T1 and DWI-derived parameters differed significantly between cervical cancer and normal cervix (all < 0.05), except D* ( 0.637). Native T1 and MK varied significantly between squamous cell carcinoma (SCC) and adenocarcinoma (both < 0.05). ADC, D, and MD were significantly lower while MK was significantly higher in the high-grade SCC group than in the low-grade SCC group (all < 0.05). LVSI-positive SCC had a significantly higher MK than LVSI-negative SCC ( < 0.05).
Both T1 mapping and multimodel DWI can effectively differentiate cervical cancer from a normal cervix and cervical adenocarcinoma from SCC. Furthermore, multimodel DWI may provide quantitative metrics for non-invasively predicting histological grade and LVSI status in SCC patients.
Combined use of T1 mapping and multimodel DWI may provide more comprehensive information for non-invasive pre-operative evaluation of cervical cancer.
评估 T1 mapping 与多模型扩散加权成像（DWI）在评估宫颈癌组织学类型、分级和脉管侵犯（LVSI）中的临床可行性。
对 80 例宫颈癌患者和 43 例正常宫颈患者进行 T1 mapping 和 DWI 检查，b 值为 11（0-2000 s/mm）。使用单指数、双指数和峰度模型拟合计算表观扩散系数（ADC）、纯分子扩散（D）、假性扩散（D*）、灌注分数（f）、平均扩散系数（MD）和平均峰度（MK）。根据组织学类型、分级和 LVSI 状态比较 T1 自然值和 DWI 衍生参数（ADC、ADC、D、D、D*、f、MD、MD、MK 和 MK）。
宫颈癌与正常宫颈之间 T1 自然值和 DWI 衍生参数存在显著差异（均<0.05），除了 D*（0.637）。T1 自然值和 MK 在鳞癌（SCC）和腺癌之间存在显著差异（均<0.05）。高级别 SCC 组的 ADC、D 和 MD 显著低于低级别 SCC 组，MK 显著高于低级别 SCC 组（均<0.05）。LVSI 阳性 SCC 的 MK 显著高于 LVSI 阴性 SCC（<0.05）。
T1 mapping 和多模型 DWI 均可有效区分宫颈癌与正常宫颈、宫颈腺癌与 SCC。此外，多模型 DWI 可能为预测 SCC 患者组织学分级和 LVSI 状态提供定量指标。
T1 mapping 与多模型 DWI 的联合应用可为宫颈癌的术前无创评估提供更全面的信息。
