| Part? The study of intravoxel incoherent motion diffusion weighted imaging quantitative parameters in the diagnosis and clinical staging of cervical cancerObjective: To investigate the value of intravoxel incoherent motion diffusion weighted imaging quantitative parameters(D,D*,f)in the diagnosis and clinical staging of cervical cancer.Methods: 32 cases with cervical cancer and 16 cases with normal cervix who were admitted to our hospital from January 2017 to December 2017 were collected.All the participants underwent routine MRI and IVIM-DWI scanning.For the post-processing,all the IVIM-DWI images were uploaded to MITK-Diffusion software.At multiple levels of the lesion,the ROI was manually delineated,and the quantitative parameters(D,D*,f)were automatically calculated.Statistical analysis were performed by SPSS 22.0 and Med Calc software.The quantitative parameters of cervical cancer group and the normal cervix group,early cervical cancer group and advanced cervical cancer group were compared using the independent sample t test and Mann-whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of cervical cancer.Results: The D,D* and f values of cervical cancer group were(0.81±0.12)×10-3mm2/s?(12.76±2.92)×10-3mm2/s?(10.29±2.87)% and that of normal cervix group were(1.17±0.15)×10-3mm2/s?(14.04±2.89)×10-3mm2/s?(21.93±5.90)%respectively.The D and f values of cervical cancer group were significantly lower than normal cervix group(P<0.001),and there was no statistical difference in D*value between the two groups(P>0.05).The D,D* and f values of early cervical cancer group were(0.80±0.12)×10-3mm2/s?(12.39±2.60)×10-3mm2/s?(10.48±3.01)%,and that of advanced cervical cancer group were(0.87±0.10)×10-3mm2/s ?(14.08±3.80)×10-3mm2/s ?(9.61±2.42)%.There were no statistically significant difference in D,D*and f values between the two groups(P>0.05).The f value had the best diagnostic performance,and the AUC was 0.981.When the diagnostic threshold was 13.63%,the sensitivity and specificity were 93.75% ? 100%respectively.Conclusion: The D and f values of IVIM-DWI can be used to identify cervical cancer and normal cervix,and the f value is the best for the diagnosis of cervical cancer.There were no significant difference in D,D*and f values between early and advanced cervical cancer group.IVIM-DWI can reflect the diffusion of water molecules and the perfusion of microcirculatory in tissue without contrast agent injection,and has important clinical value in the diagnosis of cervical cancer.Part? The study of dynamic contrast-enhanced MRI quantitative parameters in the diagnosis and clinical staging of cervical cancerObjective: To investigate the value of dynamic contrast-enhanced MRI quantitative parameters(Ktrans,Kep,Ve)in the diagnosis and clinical staging of cervical cancer.Methods: 32 cases with cervical cancer and 16 cases with normal cervix who were admitted to our hospital from January 2017 to December 2017 were collected.All the participants underwent routine MRI and DCE-MRI scanning.For the post-processing,all the DCE-MRI images were uploaded to Tissue 4D software.At multiple levels of the lesion,the ROI was manually delineated,and the quantitative parameters(Ktrans,Kep,Ve)were calculated automatically.Statistical analysis was performed by SPSS 22.0 and Med Calc software.The quantitative parameters of cervical cancer group and the normal cervix group,early cervical cancer group and advanced cervical cancer group were compared using the independent sample t test and Mann-whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of cervical cancer.Results: The Ktrans,Kep and Ve values of cervical cancer group were(0.21±0.06)min-1?(0.89±0.27)min-1?(0.25±0.08)%,and that of normal cervix group were(0.11±0.04)min-1?(0.41±0.13)min-1?(0.27±0.05)%.The Ktransand Kep values of cervical cancer group were significantly higher than that of normal cervix group(P<0.001),and there was no significant difference in Ve value between the two groups(P > 0.05).The Ktrans,Kep and Ve values of early cervical cancer group were(0.20±0.05)min-1?(0.89±0.28)min-1?(0.25±0.08)%,and that of advanced cervical cancer group were(0.26±0.06)min-1?(0.92±0.22)min-1?(0.29±0.07)%.The Ktrans value of early cervical cancer group was significantly lower than that of advanced(P<0.05),while Kep and Ve values showed no statistical difference between the two groups(P>0.05).The Kep value had the best diagnostic performance,and the AUC was 0.955.When the diagnostic threshold was 0.486 min-1,the sensitivity and specificity were 96.87%?87.50% respectively.Conclusion: The Ktrans and Kep values of DCE-MRI can be used to identify cervical cancer and normal cervix,and the Kep value is the best for the diagnosis of cervical cancer.Kep value can be used to identify early and advanced cervical cancer,which has certain reference value for guiding clinical treatment.Part ? The study of correlation between IVIM-DWI and DCE-MRI quantitative parameters in cervical cancerObjective: To investigate the correlation of quantitative parameters between IVIM-DWI(D*,f)and DCE-MRI(Ktrans,Kep,Ve)of cervical cancer.Methods: 32 cases with cervical cancer and 16 cases with normal cervix who were admitted to our hospital from January 2017 to December 2017 were collected.All the participants underwent routine MRI,IVIM-DWI and DCE-MRI scanning.For the post-processing,all the IVIM-DWI images were uploaded to MITK-Diffusion software,and the DCE-MRI images were uploaded to Tissue 4D software.The quantitative parameters including D*,f and Ktrans,Kep,Ve were automatically calculated respectively.Statistical analysis was performed by SPSS 22.0 software.The quantitative parameters of cervical cancer group and normal cervix group were compared using the independent sample t test and Mann-whitney U test.Comparing the correlation of quantitative parameters between IVIM-DWI and DCE-MRI in cercival cancer by Pearson correlation analysis.Results: The D* and f values of cervical cancer group were(12.76±2.92)×10-3mm2/s?(10.29±2.87)%,and that of normal cervix group were(14.04±2.89)×10-3mm2/s ?(21.93±5.90)% respectively.The f value of cervical cancer group was lower than normal cervix group(P<0.001),and there was no statistical difference in D* value between the two groups(P>0.05).The Ktrans,Kep and Ve values of cervical cancer group were(0.21±0.06)min-1?(0.89±0.27)min-1?(0.25±0.08)%,and that of normal cervix group were(0.11±0.04)min-1?(0.41±0.13)min-1?(0.27±0.05)%.The Ktransand Kep values of cervical cancer group were higher than that of normal cervix group(P<0.001),and there was no significant difference in Ve value between the two groups(P>0.05).There was a moderate correlation between the f and Kep values(r=0.364,P=0.040).Conclusion:The quantitative parameters f of IVIM-DWI and the quantitative parameters Ktrans,Kep of DCE-MRI can be used to identify cervical cancer and normal cervix.There was a moderate correlation between the f and Kep values.IVIM-DWI does not require injection of contrast agents,and it has certain clinical application potential for patients who can not use contrast agents such as pregnancy and renal insufficiency. |
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