The Initial Approach Of Imaging Manifestations And Clinical Application Value Of PWI、MRS In Uterine Cervix Cancer And Normal Cervix

Objective: Using magnetic resonance perfusion weighted imaging (PWI) andmagnetic resonance spectroscopy (MRS) technology, by analyzing and comparing thecharacteristics of time-signal intensity curve (TIC)、perfusion parameters and MRSbetween uterine cervix cancer and normal cervix, to explore imaging manifestations andclinical application value of PWI、MRS in them.Materials and Methods:15normal cases and35patients with pathologicallydiagnosed cervical carcinoma were collected.15patients were treated with operation,while20patients were treated with radical radiation. According to the radiotherapyresponse,20cases were classified as the effective group and the ineffective group. MRroutine scanning, DWI, MRS, PWI and enhanced scanning were performed in all.20cases repeated the same examinations after3weeks posterior to radiotherapy.The results of respective region of interest were obtained, including MRS、TIC typesand relative perfusion parameters(Peak height、Maximum slope of increase、Time topeak). The results of uterine cervix cancer and normal cervix、the squamous carcinomaand the adenocarcinoma、prior and posterior to the radiotherapy、as well as the effective group and the ineffective group were compared respectively.Results:1. The comparisons of TIC:(1)35cases with cervical cancer were mainly showed“rapid rise then gradual decline type”, namely a notable upslope、arrive to the peakquickly、then turn to a long plateau, including “rapid rise then gradual decline type”29cases、“rapid rise and down type”4cases、“gradual rise type”2cases.(2)15normalcases were predominated “gradual rise type”, namely slope up slowly and gradually,including “gradual rise type”11cases、“rapid rise then gradual decline type”4cases.2. The comparisons of perfusion parameters:(1) PH、MSI of cervical cancer groupwere higher than normal group, while TTP was lower than normal group, there weresignificant difference (PPH=0.000,PMSI=0.000,PTTP=0.000).(2) PH、MSI of squamouscarcinoma were lower than adenocarcinoma, while TTP was higher thanadenocarcinoma, there were no significant difference (PPH=0.321,PMSI=0.586,PTTP=0.082).(3) PH and MSI were higher before radiotherapy than those after radiotherapy,while TTP delayed after radiotherapy, there were significant difference(PPH=0.000,PMSI=0.000,PTTP=0.000).(4) PH、MSI of the effective group were higherthan the ineffective group, there were significant difference (PPH=0.025,PMSI=0.004),while TTP was lower than the ineffective group, there were no significant difference(PTTP=0.324).3. The analysis of MRS:(1) MRS shape of cervical cancer group could beconcluded on the whole：Cho peak、Lip peak and Cr peak appeared concurrently, whileCho peak was high、Lip peak increased remarkablely, namely Lip peak>Cho peak>Cr peak.(2) Cho peak, Lip peak and Cr peak couldn’t be found in the MRS shape ofnormal group.Conclusion:1. Perfusion and hemodynamics state of the tissue can be reflected by PWIthrough TIC and perfusion parameters, which can be used to distinguish uterine cervixcancer and normal cervix, it plays an important role in diagnosis of cervical cancer、monitoring treatment effectiveness and predicting chemoradiation sensitivity.2.1H–MRS can be used to monitor metabolic change of cervical cancer invivo atraumatically, it can provide molecular metabolic information for thediagnosis and treatment of cervical cancer.