MRI常规扫描及弥散加权成像在宫颈癌评价中的价值_West China Medical Journal

Authors：

 李玉明 ¹ , 唐鹤涵 ¹ , 李真林 ¹ ,  程燕 ²

1. ;
2. ;

Corresponding author：

程燕, Email: yanchee@qq.com

Keywords：

磁共振成像; 常规扫描; 弥散加权成像; 宫颈癌

DOI：

10.7507/1002-0179.20150341

Video：

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MRI常规扫描凭借着较高的软组织分辨率对宫颈癌肿块在宫颈内部的生长情况、肿块对宫体的侵犯程度以及对宫旁癌周的侵犯、宫旁闭孔区淋巴结转移的评价方面具有较高准确性和特异性。MRI常规扫描可提高宫颈癌的定位、定性、分期的准确性，有助于临床国际妇产科联盟（FIGO）分期。MRI弥散加权成像，作为功能磁共振的一种，是唯一一种可以评价活体组织内水分子弥散状况的扫描方法，利用弥散加权成像获得表观弥散系数值可以对宫颈癌病灶组织病理学类型及分化程度、宫旁侵犯、淋巴结转移进行定量定性分析。将弥散加权成像与常规扫描结合起来在诊断宫颈癌、协助临床FIGO分期、制订优化个体化治疗方案及预后预测上有较大临床应用价值。

Citation： 李玉明, 唐鹤涵, 李真林, 程燕. MRI常规扫描及弥散加权成像在宫颈癌评价中的价值. West China Medical Journal, 2015, 30(6): 1183-1186. doi: 10.7507/1002-0179.20150341 Copy

1.	李霓, 郑荣寿, 张思维, 等. 2003~2007年中国宫颈癌发病与死亡分析[J]. 中国肿瘤, 2012, 21(11):801-804.
2.	黄永刚, 帅茨霞, 胡燕. 宫颈癌年轻化发病相关因素研究进展[J]. 国外医学:妇产科学分册, 2005, 32(3):186-189.
3.	姜艳. 宫颈癌发病年轻化趋势的研究现状[J]. 医学综述, 2012, 18(24):4166-4169.
4.	Haggar FA, Preen DB, Pereira G, et al. Cancer incidence and mortality trends in Australian adolescents and young adults, 1982-2007[J]. BMC Cancer, 2012, 20(12):151.
5.	Eifel PJ, Berek JS, Thigpen JT. Cancer of the cervix vagina, and vulva[C]//DeVitaVT, Philadelphia, Pa:Lippineott, 1997:1433-1475.
6.	Subak LL, Hricak H, Powell CB, et al. Cervical carcinoma:computed tomography and magnetic resonance imaging for preoperative staging[J]. Obstet Gynecol, 1995, 86(1):43-50.
7.	Fischerová D, Cibula D, Stenhová H, et al. Use of transrectal ultrasound and magnetic resonance imaging in the staging of early-stage cervical cancer[J]. Ceská Gynekol, 2009, 74(5):323-329.
8.	张静, 袁小东, 王培军. 1.5 T磁共振对宫颈癌手术可切除性判断的准确性分析[J]. 中国医学计算机成像杂志, 2012, 18(5):412-414.
9.	Nicolet V, Carignan L, Bourdon F, et al. Mr imaging of cervical carcinoma:a practical staging approach[J]. Radiographics, 2001, 20(6):1539-1549.
10.	江新青, 谢琦, 梁长虹, 等. 宫颈癌的MRI诊断与分期研究[J]. 中华放射学杂志, 2002, 36(7):621-625.
11.	Stenstedt K, Hellström AC, Fridsten S, et al. Impact of MRI in the management and staging of cancer of the uterine cervix[J]. Acta Oncol, 2011, 50(3):420-426.
12.	Yasuda S, Kojima A, Maeno Y, et al. Poor prognosis of patients with stage Ⅰb1 adenosquamous cell carcinoma of the uterine cervix with pelvic lymphnode metastasis[J]. Kobe J Med Sci, 2006, 52(1/2):9-15.
13.	Hashimoto I, Kodama J, Seki N, et al. Vascular endothelial growth factor-C expression and its relationship to pelvic lymph node status in invasive cervical cancer[J]. Br J Cancer, 2001, 85(1):93-97.
14.	Scheidler JJ, Hricak H, Yu KK, et al. Radiological evaluation of lymph node metastases in patients with cervical cancer: a metaanalysis[J]. JAMA, 1997, 278(13):1096-1101.
15.	李燕, 王銮虹, 朱安娜, 等. Ⅰ B1~Ⅱ B期宫颈癌盆腔淋巴结转移的分布特点及其对预后的影响[J]. 实用妇产科杂志, 2013, 29(8):598-602.
16.	Chung HH, Kang SB, Cho JY, et al. Can preoperative MRI accurately evaluate nodal and parametrial invasion in early stage cervical cancer?[J]. Jpn J Clin Oncol, 2007, 37(5):370-375.
17.	Hancke K, Heilmann V, Straka P, et al. Pretreatment staging of cervical cancer:is imaging better than palpation? Role of CT and MRI in preoperative staging of cervical cancer:single institution results for 255 patients[J]. Ann Surg Oncol, 2008, 15(10):2856-2861.
18.	Sahdev A, Sohaib SA, Wenaden AE, et al. The performance of magnetic resonance imaging in early cervical carcinoma:a long-term experience[J]. Int J Gynecol Cancer, 2007, 17(3):629-636.
19.	Lam WW, So NM, Yang WT, et al. Detection of parametrial invasion in cervical carcinoma:role of short tau inversion recovery sequence[J]. Clin Radiol, 2000, 55(9):702-707.
20.	Taouli B, Koh DM. Diffusion-weighted Mr imaging of the liver[J]. Radiology, 2010, 254(1):47-66.
21.	McVeigh PZ, Syed AM, Milosevic M, et al. Diffusion-weighted MRI in cervical cancer[J]. Eur Radiol, 2008, 18(5):1058-1064.
22.	Brisigotti M, Cozzutto C, Fabbretti G, et al. Metanephric adenoma[J]. Histol Histopathol, 1992, 7(4):689-692.
23.	Naganawa S, Sato C, Kumada H, et al. Apparent diffusion coefficient in cervical cancer of the uterus:comparison with the normal uterine cervix[J]. Eur Radiol, 2005, 15(1):71-78.
24.	Liu Y, Bai R, Sun H, et al. Diffusion-weighted magnetic resonance imaging of uterine cervical cancer[J]. J Comput Assist Tomogr, 2009, 33(6):858-862.
25.	张赟, 梁碧玲, 高立, 等. 正常子宫颈和宫颈癌的弥散加权成像特点[J]. 癌症, 2007, 26(5):508-512.
26.	贺李, 余深平, 庄晓曌, 等. 子宫颈癌3.0 T磁共振弥散加权成像与病理的初步相关研究[J]. 中华临床医师杂志:电子版, 2011, 5(2):363-367.
27.	Hoogendam JP, Klerkx WM, De Kort GA, et al. The influence of the b-value combination on apparent diffusion coefficient based differentiation between malignant and benign tissue in cervical cancer[J]. J Magn Reson Imaging, 2010, 32(2):376-382.
28.	Chen YB, Hu CM, Chen GL, et al. Staging of uterine cervical carcinoma:whole-body diffusion-weighted magnetic resonance imaging[J]. Abdom Imaging, 2011, 36(5):619-626.
29.	Andrews RT, Brown PH. Uterine arterial embolization:factors influencing patient radiation exposure[J]. Radiology, 2000, 217(3):713-722.
30.	Liu S, Semenciw R, Probert A, et al. Cervical cancer in Canada:changing patterns in incidence and mortality[J]. Int J Gynecol Cancer, 2001, 11(1):24-31.
31.	Kuang F, Ren J, Zhong Q, et al. The value of apparent diffusion coefficient in the assessment of cervical cancer[J]. Eur Radiol, 2013, 23(4):1050-1058.
32.	Yu SP, He L, Liu B, et al. Differential diagnosis of metastasis from non-metastatic lymph nodes in cervical cancers:pilot study of diffusion weighted imaging with background suppression at 3T magnetic resonance[J]. Chin Med J (Engl), 2010, 123(20):2820-2824.
33.	Xue HD, Li S, Sun F, et al. Clinical application of body diffusion weighted Mr imaging in the diagnosis and preoperative N staging of cervical cancer[J]. Chin Med Sci J, 2008, 23(3):133-137.
34.	Lin G, Ho KC, Wang JJ, et al. Detection of lymph node metastasis in cervical and uterine cancers by diffusion-weighted magnetic resonance imaging at 3T[J]. J Magn Reson Imaging, 2008, 28(1):128-135.

1. 李霓, 郑荣寿, 张思维, 等. 2003~2007年中国宫颈癌发病与死亡分析[J]. 中国肿瘤, 2012, 21(11):801-804.
2. 黄永刚, 帅茨霞, 胡燕. 宫颈癌年轻化发病相关因素研究进展[J]. 国外医学:妇产科学分册, 2005, 32(3):186-189.
3. 姜艳. 宫颈癌发病年轻化趋势的研究现状[J]. 医学综述, 2012, 18(24):4166-4169.
4. Haggar FA, Preen DB, Pereira G, et al. Cancer incidence and mortality trends in Australian adolescents and young adults, 1982-2007[J]. BMC Cancer, 2012, 20(12):151.
5. Eifel PJ, Berek JS, Thigpen JT. Cancer of the cervix vagina, and vulva[C]//DeVitaVT, Philadelphia, Pa:Lippineott, 1997:1433-1475.
6. Subak LL, Hricak H, Powell CB, et al. Cervical carcinoma:computed tomography and magnetic resonance imaging for preoperative staging[J]. Obstet Gynecol, 1995, 86(1):43-50.
7. Fischerová D, Cibula D, Stenhová H, et al. Use of transrectal ultrasound and magnetic resonance imaging in the staging of early-stage cervical cancer[J]. Ceská Gynekol, 2009, 74(5):323-329.
8. 张静, 袁小东, 王培军. 1.5 T磁共振对宫颈癌手术可切除性判断的准确性分析[J]. 中国医学计算机成像杂志, 2012, 18(5):412-414.
9. Nicolet V, Carignan L, Bourdon F, et al. Mr imaging of cervical carcinoma:a practical staging approach[J]. Radiographics, 2001, 20(6):1539-1549.
10. 江新青, 谢琦, 梁长虹, 等. 宫颈癌的MRI诊断与分期研究[J]. 中华放射学杂志, 2002, 36(7):621-625.
11. Stenstedt K, Hellström AC, Fridsten S, et al. Impact of MRI in the management and staging of cancer of the uterine cervix[J]. Acta Oncol, 2011, 50(3):420-426.
12. Yasuda S, Kojima A, Maeno Y, et al. Poor prognosis of patients with stage Ⅰb1 adenosquamous cell carcinoma of the uterine cervix with pelvic lymphnode metastasis[J]. Kobe J Med Sci, 2006, 52(1/2):9-15.
13. Hashimoto I, Kodama J, Seki N, et al. Vascular endothelial growth factor-C expression and its relationship to pelvic lymph node status in invasive cervical cancer[J]. Br J Cancer, 2001, 85(1):93-97.
14. Scheidler JJ, Hricak H, Yu KK, et al. Radiological evaluation of lymph node metastases in patients with cervical cancer: a metaanalysis[J]. JAMA, 1997, 278(13):1096-1101.
15. 李燕, 王銮虹, 朱安娜, 等. Ⅰ B1~Ⅱ B期宫颈癌盆腔淋巴结转移的分布特点及其对预后的影响[J]. 实用妇产科杂志, 2013, 29(8):598-602.
16. Chung HH, Kang SB, Cho JY, et al. Can preoperative MRI accurately evaluate nodal and parametrial invasion in early stage cervical cancer?[J]. Jpn J Clin Oncol, 2007, 37(5):370-375.
17. Hancke K, Heilmann V, Straka P, et al. Pretreatment staging of cervical cancer:is imaging better than palpation? Role of CT and MRI in preoperative staging of cervical cancer:single institution results for 255 patients[J]. Ann Surg Oncol, 2008, 15(10):2856-2861.
18. Sahdev A, Sohaib SA, Wenaden AE, et al. The performance of magnetic resonance imaging in early cervical carcinoma:a long-term experience[J]. Int J Gynecol Cancer, 2007, 17(3):629-636.
19. Lam WW, So NM, Yang WT, et al. Detection of parametrial invasion in cervical carcinoma:role of short tau inversion recovery sequence[J]. Clin Radiol, 2000, 55(9):702-707.
20. Taouli B, Koh DM. Diffusion-weighted Mr imaging of the liver[J]. Radiology, 2010, 254(1):47-66.
21. McVeigh PZ, Syed AM, Milosevic M, et al. Diffusion-weighted MRI in cervical cancer[J]. Eur Radiol, 2008, 18(5):1058-1064.
22. Brisigotti M, Cozzutto C, Fabbretti G, et al. Metanephric adenoma[J]. Histol Histopathol, 1992, 7(4):689-692.
23. Naganawa S, Sato C, Kumada H, et al. Apparent diffusion coefficient in cervical cancer of the uterus:comparison with the normal uterine cervix[J]. Eur Radiol, 2005, 15(1):71-78.
24. Liu Y, Bai R, Sun H, et al. Diffusion-weighted magnetic resonance imaging of uterine cervical cancer[J]. J Comput Assist Tomogr, 2009, 33(6):858-862.
25. 张赟, 梁碧玲, 高立, 等. 正常子宫颈和宫颈癌的弥散加权成像特点[J]. 癌症, 2007, 26(5):508-512.
26. 贺李, 余深平, 庄晓曌, 等. 子宫颈癌3.0 T磁共振弥散加权成像与病理的初步相关研究[J]. 中华临床医师杂志:电子版, 2011, 5(2):363-367.
27. Hoogendam JP, Klerkx WM, De Kort GA, et al. The influence of the b-value combination on apparent diffusion coefficient based differentiation between malignant and benign tissue in cervical cancer[J]. J Magn Reson Imaging, 2010, 32(2):376-382.
28. Chen YB, Hu CM, Chen GL, et al. Staging of uterine cervical carcinoma:whole-body diffusion-weighted magnetic resonance imaging[J]. Abdom Imaging, 2011, 36(5):619-626.
29. Andrews RT, Brown PH. Uterine arterial embolization:factors influencing patient radiation exposure[J]. Radiology, 2000, 217(3):713-722.
30. Liu S, Semenciw R, Probert A, et al. Cervical cancer in Canada:changing patterns in incidence and mortality[J]. Int J Gynecol Cancer, 2001, 11(1):24-31.
31. Kuang F, Ren J, Zhong Q, et al. The value of apparent diffusion coefficient in the assessment of cervical cancer[J]. Eur Radiol, 2013, 23(4):1050-1058.
32. Yu SP, He L, Liu B, et al. Differential diagnosis of metastasis from non-metastatic lymph nodes in cervical cancers:pilot study of diffusion weighted imaging with background suppression at 3T magnetic resonance[J]. Chin Med J (Engl), 2010, 123(20):2820-2824.
33. Xue HD, Li S, Sun F, et al. Clinical application of body diffusion weighted Mr imaging in the diagnosis and preoperative N staging of cervical cancer[J]. Chin Med Sci J, 2008, 23(3):133-137.
34. Lin G, Ho KC, Wang JJ, et al. Detection of lymph node metastasis in cervical and uterine cancers by diffusion-weighted magnetic resonance imaging at 3T[J]. J Magn Reson Imaging, 2008, 28(1):128-135.

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MRI常规扫描及弥散加权成像在宫颈癌评价中的价值

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