| BackgroundConventional diffusion-weighted imaging?DWI?reflects the diffusion of water molecules,but it ignores microcirculation perfusion of capillary blood flow,whereas intravoxel incoherent motion diffusion-weighted imaging?IVIM-DWI?is able to separate diffusion of water molecules from perfusion information of capillary microcirculation of tumor tissue,and It can well reflect the differences between the intensity of cervical cancer cells and the perfusion of microcirculation,which may indirectly reflect the degree of differentiation of malignant tumor tissues;it is possible to reflect more accurately the cell density and microcirculation information of benign and malignant prostatic nodules than the conventional single b-value DWI.Objective1.To evaluate the correlation between parameters of intravoxel incoherent motion diffusion-weighted imaging and the pathological types of cervical cancer and pathological differentiation degree of cervical squamous cancer.2.To investigate the correlation between the parametric values of intravoxel incoherent motion diffusion-weighted imaging?IVIM-DWI?and blood level and cellular density in uterine fibroids with 3.0T magnetic resonance imaging?MRI?.3.To evaluate the value of intravoxel incoherent motion diffusion-weighted imaging?IVIM-DWI?on distinguishing prostate cancer?PCa?and benign prostate hyperplasia?BPH?at 3.0 T.Methods1.Retrospective analysis of 98 cases patients of cervical cancer?87 cases cervical squamous cancer and 11 cases cervical adenocarcinoma?confirmed by surgery and pathology in our hospital was included in this study,which eleven cases were highly differentiation squamous cancer group,twenty six cases were in the middle differentiation squamous cancer group and fifty cases were in the low differentiation squamous cancer group,the conventional magnatic resonance imaging and intravoxel incoherent motion diffusion-weighted imaging examinations were performed in all patients,intravoxel incoherent motion diffusion-weighted imaging was performed by using 10 b values?b=0,10,20,50,100,200,400,800,1200,2000 s/mm2?.Application Functool software of GE ADW4.5 workstation respectively were ADCstand,pure water molecular diffusion coefficient?D?,pseudo diffusion coefficient?D*?and perfusion fraction?f?of IVIM-DWI related parameter values.Statistical analysis software SPSS 22.0 was used in between cervical cancers and IVIM-DWI related parameter values,the receiver operating characteristic?ROC?curve was sued to distinguish the efficiency of of cervical cancer.2.Twenty two patients with twenty nine uterine fibroids that are diagnosed clinically are scanned with MRI nonenhanced,enhanced and IVIM-DWI sequences before the treatment of High intensity focused ultrasound?HIFU?,ADCstand,D,D*and f values of fibroids and normal muscle were respectively measured on AW4.5 workstation after scanning.The means of relative parameters which obtained are served the parametric values of uterine fibroids combine the signal intensity and enhanced degree of fibroids in T2 weight imaging,all results were statistically analyzed.3.This retrospective study was approved by biopsy and surgical pathology,forty eight patients were divided into group PCa?n=28?and BPH?n=20?.The conventional Magnatic Resonance Imaging and IVIM-DWI examination were performed in all patients,IVIM-DWI was performed by using 11 b values?0,10,20,50,100,200,400,800,1200,2000,3000 s/mm2?.To calculate ADCstand,D,D*and f values on the basis of the IVIM model in GE AW4.5 workstation,ROI was placed lesions center and account for two-thirds of the lesions;Avoiding the seminal vesicle,calcification and hemorrhage.Independent samples group t test were performed to calculated the statistical significance between PCa and BPH.the receiver operating characteristic?ROC?curve was sued to distinguish the efficiency of PCa and BPH,and receiving corresponding the areas under the ROC curve?AUC?,cut-off values,sensitivity and specificity.Results1.The ADCstandand D values of cervical squamous cell carcinoma were?0.73±0.11?×10-3mm2/s,?0.52,0.14?×10-3mm2/s,respectively,lower than that of adenocarcinoma?0.93±0.26?×10-3mm2/s,?0.75,0.10?×10-3mm2/s,and they have statistical significance?P<0.05?;D*,f values were not statistically significant.The ADCstand,D,D*and f values of low differentiation group cervical squamous cancer were?0.72±0.11?×10-3mm2/s,?0.45±0.067?×10-3mm2/s,?7.56±3.09?×10-3mm2/s and?39.55,14.25?%;The ADCstand,D,D*and f values of middle differentiation group cervical squamous cancerwere?0.74±0.11?×10-3mm2/s,?0.58±0.036?×10-3mm2/s,?17.19±4.37?×10-3mm2/s and?24.05,3.73?%;The ADCstand,D,D*and f values of highly differentiation group cervical squamous cancer were?0.78±0.073?×10-3mm2/s,?0.74±0.024?×10-3mm2/s,?39.18±10.09?×10-3mm2/s and?18.70,1.60?%;There are statistical significance in the D,D*and f values of inter-groups?P<0.05?,but there is no statistical significance in the ADCstandtand of inter-groups.The D and D*values were positively correlated with the pathological differentiation of cervical squamous cancer?r was 0.853,0.880?,and the f value was moderately negative correlation?r=-0.730?.In the diagnosis of low differentiation and high differentiation of cervical squamous cell carcinoma,the D value had the best diagnostic efficiency;In the diagnosis of cervical squamous cell carcinoma,f value has the best diagnostic efficiency.2.The signal performance of all fibroids on the T2WI repressive sequence:high signal?8/29?,intermediate signal?16/29?,low signal?5/29?;Enhanced degree:high enhancement?10/29?,moderate enhancement?9/29?,mild enhancement?10/29?.ADCstand,D,D*and f values of uterine fibroids were?0.85±0.20?×10-3mm2/s??0.72±0.43?×10-3mm2/s??16.47±10.51?×10-3mm2/s?0.44±0.20.ADCstand,D,D*and f values of Normal muscle were?1.06±0.10?×10-3mm2/s??1.16±0.15?×10-3mm2/s??68.69±51.92?×10-3mm2/s?0.32±0.094.The difference of ADCstand,D,D*and f values in uterine fibroids and normal uterine muscle were statistically significant?P<0.05?.fastast ADC and f values of uterine fibroids and the enhanced degree of the fibroids were positive,negative correlation?r values were 0.505,-0.454?.3.The ADCstand,D values of the group PCa were?0.62±0.12?×10-3mm2/s,?0.43±0.13?×10-3mm2/s,which lower than those of the group BPH?1.07±0.24?×10-3mm2/s,?0.73±0.21?×10-3mm2/s;The f value of the group PCa was?32.63±12.83?%,which higher than one of the group BPH?23.59±10.07?%;There are statistical significance between the two groups?P<0.05?.The D*of the group PCa was?16.51±9.42?×10-33 mm2/s,and D*of the group BPH was?11.89±10.39?×10-3mm2/s.There was no statistical significance between the two groups?P=0.359?.The cutoff value,AUC,sensitivity and specificity of diagnosing PCa were 0.746×10-3mm2/s,0.962,94.1%and 87%for ADCstand;0.44×10-3mm2/s,0.884,97.1%and 67.5%for D;29.5%?0.660?70.6%and 54.2%for f value.Conclusion1.The D,D*and f values of IVIM-DWI non-invasively assess the pathological types of cervical cancer and pathological differentiation degree of cervical squamous cancer,It is helpful for the clinical to develop a scientific and individualized treatment plan of cervical cancer,so as to improve the efficacy of cervical cancer.2.The D value of IVIM-DWI sequence can reflect cellular density of uterine fibroids than ADCstandtand value;The D*and f values of it contribute to identify the rich blood supply of uterine fibroids without enhancement.3.The values of the ADC,D,f valves IVIM-DWI have a certain the identification for prostate cancer nodules and benign prostatic hyperplastic nodules.The ADCstandtand value afforded a better diagnostic performance than other parameters. |
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