| Objective: To investigate the sensitivity and accuracy rate of MR diffusion weighted imaging (DWI) in detecting tumors of uterine cervix. To discuss the value of apparent diffusion coefficient (ADC) in discriminating of the normal cervix and uterine cervix cancer (UCC).Material and Methods: 20 healthy female and 67 UCC patients were selected and scanned with routine pelvic MR sequences and DWI on sagittal planes and axial planes. DWI of sagittal plane is performed with b value of 500 s/mm2, 800s/mm2,and 1000s/mm2, and the axial plane is 800 s/mm2. Three-layered structures of normal cervix on each image were analyzed and contrasted. With contrast, b value of 800 s/mm2 was chose as the experiment one. ADC values of the normal cervix were compared. 67 UCCs were diagnosed by two doctors using double blind method, and staged by UCC FIGO 1995. The sensitivity and accuracy rate of DWI and routine MRI sequences in detecting UCC were contrasted. The ADC values of normal uterine cervix (cervical endometrial, junctional zone, and myometrium) and cervical carcinoma were compared.Results: For normal volunteers, normal uterine cervix (cervical endometrial, junctional zone, and myometrium) were clearly displayed on DWI. UCC was displayed hyperintenstiy on DWI. (1)In 67 UCC, routine MRI sequences detected 64 UCC, with the accuracy rate of 95.6%; on DWI with routine MRI sequences, all lesions were clearly displayed, with the accuracy rate of 100%. (2)UCCs staging: on routine MRI sequences, 9 UCCs staging were not conformed with pathology, 58 UCCs were conformed with pathology, the accuracy rating was 86.6%;On DWI and routine MRI sequences, only 4 UCCs were not conformed, 63 UCCs were right, the accuracy rate was 94%. There were no significant differences between them through X2 test. (3)In control group, the average ADC of three-layer structure of normal cervixwas as followed: cervical endometrial(1.54±0.15)×10-3mm2/s, junctional zone(1.56±0.16)×10-3mm2/s, myometrium (1.81±0.16)×10-3mm2/s. By contrast, the difference between cervical endometrial and junctional zone was not statistically significant, while the differences between cervical endometrial and myometrium , junctional zone and myometrium were statistically significant. The average ADC of UCC was (1.05±0.20)×10-3mm2/s, and the difference between UCC and cervical endometrial was statistically significant.Conclusion: UCCs were detected more sensitively with DWI and routine MRI sequences than with routine MRI sequences only. But on the UCC staging, they were no differences. DWI had great clinical significance in distinguishing cervical carcinoma from normal uterine. Threshold of UCC is 1.11×10-3mm2/s.
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