The Value Research Of IVIM-DWI And DCE-MRI In The Evaluation Of Cervical Cancer

ObjectiveTo investigate the application value of IVIM-DWI and DCE-MRI in the diagnosis,pathological grading and clinical staging of cervical carcinoma,as well as the relationship with Microvessel density(MVD)and the correlation between MVD and cervical cancer pathological grading and clinical staging.MethodsThe case group was 34 patients who were treated with MRI examination and pathologically confirmed cervical cancer from May 2016 to April 2017 in our hospital,control group was 26 cases who were treated with MRI examination in the same period in our hospital due to uterine fibroids,endometrial cancer I A phase.All patients underwent pelvic MRI,IVIM-DWI and DCE-MRI scans.In the case group,Microvessel density(MVD)was counted with CD34 as marker.Using two independent sample t-tests,area under the receiver operating characteristic curve,and Pearson correlation assessment IVIM-DWI and DCE-MRI for the diagnosis of cervical cancer;using one-way analysis of variance and two independent samples t-test to evaluate IVIM-DWI and The value of DCE-MRI in the pathological grading and clinical staging of squamous cell carcinoma of the uterine cervix;correlation of MVD with IVIM-DWI,DCE-MRI,pathological grading,and clinical staging using Pearson correlation.Results(1)The case group D~*,f,Ktrans,Kep and Ve were significantly higher than the control group,the case group ADC and D value were significantly lower than the control group,the difference was statistically significant(p<0.05).The Ktrans curve of the case group was the largest(0.958),and the sensitivity and specificity were86.7%and 100%respectively.f is positively correlated with Ktrans and Kep(r=0.446,0.400,p<0.05).(2)ADC and D values decrease with the pathological grading of tumor tissue,and the correlation coefficients of-0.636 and-0.682;ktrans,Kep and D~*are increasing with the deterioration of pathological grading of tumor tissue,the correlation coefficients are 0.446,0.448 and 0.614 respectively.The difference of the parameters between the high differentiation and middle and low differentiation was statistically significant,but the difference of D value between middle differentiation and low differentiation was statistically significant.(3)The Ktrans,Kep,Ve,D~*and f values of the phased<ⅡB group were lower than that in the stage≥ⅡB group,and the difference was statistically significant.The ROC curve shows that f has the largest area under the curve and is 0.844.(4)Correlation analysis showed that Ktrans,Kep,Ve,D~*and f were positively correlated with MVD,in which Ktrans and D~*were highly positive correlated with MVD,and the correlation coefficients were 0.898 and 0.818.The MVD count increased with the deterioration of pathological grading,the correlation coefficient was 0.485,the clinical stage MVD Count≥ⅡB was higher than<ⅡB,the difference was statistically significant,and the correlation coefficient between MVD and clinical stage was 0.352.Conclusion(1)The diagnostic efficiency of DCE-MRI is better than IVIM-DWI.The perfusion parameters of IVIM-DWI were positively correlated with the quantitative perfusion parameters of DCE-MRI.(2)The evaluation value of IVIM-DWI on the pathological level of cervical squamous cell carcinoma is better than DCE-MRI.(3)IVIM-DWI is superior to DCE-MRI in evaluating the clinical staging of cervical cancer.(4)IVIM-DWI and DCE-MRI reflect the microcirculation state of tumor tissue.MVD plays an important role in tumor growth and invasion.