Application of DWI combined with MRI in diagnostic staging and decision of treatment method in patients with cervical cancer / 肿瘤

ABSTRACT

Objective: To explore the value of diffusion-weighted imaging (DWI) combined with conventional magnetic resonance imaging (MRI) in diagnostic staging and the decision of treatment method in patients with cervical cancer. Methods: The data of DWI MRI from 42 patients pathologically confirmed with cervical cancer were retrospectively analyzed. The apparent diffusion coeffcient (ADC) and exponential ADC (eADC) values were measured. The ADC and eADC values were compared according to different pathologic types and stages of cervical cancer, and between the cervical cancer and normal cervix. The diagnostic accuracy of DWI combined with conventional MRI for pathologic staging was examined. The ADC and eADC values were compared between radiochemotherapy group and the surgery group. Results: The cervical cancer demonstrated high signal intensity on DWI, whereas the normal cervix showed no obviously abnormal signal intensity. The mean ADC value of 42 patients with cervical cancer was lower than that of normal cervix (P = 0.000); the mean ADC value of cervical squamous-cell cancer was lower than that of adenocarcinoma (P = 0.036); the mean ADC value of radiochemotherapy group before treatment was lower than that of surgery group (P = 0.000), whereas the eADC value was higher than that of surgery group (P = 0.000). There were no significant differences in mean ADC and eADC values among different pathologic stages of cervival cancer (all P values < 0.05). The diagnostic accuracy of conventional MRI and DWI combined with conventional MRI for pathologic staging were 92.9% (39/42) and 95.2% (40/42), respectively (Kappa = 0.903 5 and 0.935 8, respectively; P < 0.01). Conclusion: DWI combined with MRI exerts a high value in diagnostic staging of cervical cancer. The ADC value can be used as reference in selection of therapeutic methods for stage II B cervical cancer.