| ObjectiveThis study was to analyze the diffusion weighted imaging(DWI) features of normal uterine cervix and cervix carcinoma,and assess the value of DWI in diagnosis and indicate the pathological type and evaluate the pathological grading and monitor of uterine cervix cancer after chemotherapy.Subjects and methodsnormal control group:15 healthy female,betweeen 18-38 years age,average age(27.60±3.851).All volunteers had no history of gyneclolgical diseases,gyneclolgical diseases were excluded by routine gyneclolgical examination parallel conventional MRI examination showed no pelvic lesions and diffuse lesions.cervical cancer group:Collection 52 patients with cervical cancer from October 2009 to February 2010 in our hospital gyneclolgical admissions,betweeen23-65years age,average age(43.23±9.25),all cases were confiremed by surgery pathology or cervical biopsy,9 cases in which were preinvasive carcinoma,and 43 cases were progressive cancer(35 case squamous carcinoma,8 case adenocarcinoma),all cases had not received any treatment before MRI examination,9 squamous carcinoma cases had received chemotherapy after examination,then reviewed MRI examination after 28 days.The Conventional and DWI of sagittal planes and axial planes were performed in 52 female patients with uterine cervix cancer and 15 healthy female. The b value of DWI were selected 300s/mm2,600s/mm2,900s/mm2.With contrast, b value of 900 s/mm2 was chose as the experiment one.Comparison the ADC value between the normal uterine cervix's three-tier structure and the normal uterine cervix with cervical cancer, Comparison the ADC value between squamous carcinoma and adenocarcinoma, comparison the ADC value of different pathological levels of squamous carcinoma, comparison the ADC value of the nine cases of cervical cancer before and after chemotherapy.ResultsFor normal volunteers, normal uterine cervix's cervical endometrial, junctional zone, and myometrium were clearly displayed on DWI.The mean ADC value of cervical endometrial was (1.8041±0.1074)×10-3mm2/s, junctional zone's was (1.2204±0.1494)×10-3mm2/s, myometrium's was (1.8906±0.1326)×10-3mm2/s. By contrast,the differences between cervical endometrial and junctional zonejunctional zone and myometrium were statistically significant P< 0.05), while the difference between cervical endometrial and myometrium was not statistically significant (P>0.05). The mean ADC value of preinvasive carcinoma was(1.6455±0.2217)×10-3mm2/s, the differences between cervical endometrial and preinvasive carcinoma were statistically significant P< 0.05). The mean ADC value of cervical cancer was (0.8802±0.1304)×10-3mm2/s, the differences between cervical endometrial and cervical cancer were statistically significant P< 0.05). The mean ADC value of squamous carcinoma cervical cancer was (0.8985±0.1349)×10-3mm2/s, The mean ADC value of adenocarcinoma cervical cancer was (1.0375±0.1590)×10-3mm2/s, the differences between cervical squamous carcinoma and adenocarcinoma of the cervical cancer were statistically significant P< 0.05). The mean ADC value of well-differentiated squamous carcinoma cervical cancer was (1.0720±0.1308)×10-3mm2/s, the moderately differentiated's was (0.9045±0.0705)×10-3mm2/s, the poorly differentiated's was (0.7509±0.0493)×10-3mm2/s, the differences along them were statistically significant.In nine patients treated by chemotherapy, The mean ADC value before chemotherapy was (0.8751±0.0950) x10-3mm2/s, The mean ADC value after chemotherapy was (1.2111±0.1217)×10-3mm2/s, The difference had statistic significance (P< 0.05),but was still lower than that of normal cervical endometrial.ConclusionDWI has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix, and it can indicate the pathological type and evaluate the pathological grading of uterine cervix cancer as well, and has important value on monitoring of cervical cancer chemotherapy,,this providing a new method for diagnosising and evaluating the pathological grading and monitoring of uterine cervix cancer after chemotherapy.
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