The Value of DCE-MRI Combined with IVIM-DWI in the Diagnosis of Cervical Cancer Lymph Node Metastasis
Objective To analyze the predictive value of dynamic enhancedmagnetic resonance imaging(DCE-MRI)combined with intravoxel incoherentmotion diffusion-weighted imaging(IVIM-DWI)for cervical cancer lymph node metastasis,and to provide reference for the diagnosis and treatment of cervical cancer lymph node metastasis.Methods A retrospective analysis was conducted on the clinical data of 103 cervical cancer patients admitted to our hospital from June 2021 to June 2023 and confirmed by pathology.They were divided into a metastatic group(26 cases)and a non metastatic group(77 cases)based on whether pelvic lymph node metastasis occurred.DCE-MRI and IVIM-DWI were performed before radical hysterectomy to obtain relevant examination parameters[DCE-MRI parameters included volume transfer constant(Ktrans),rate constant(Kep),extravascular space volume fraction(Ve),IVIM-DWI parameters included apparent diffusion coefficient(ADC),pure diffusion coefficient(D),pseudo-diffusion coefficient(D*)and perfusion fraction(f)].The differences of DCE-MRI and IVIM-DWI parameters between the two groups were compared,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of DCE-MRI combined with IVIM-DWI for lymph node metastasis of cervical cancer.Results In the IVIM-DW parameters,the D value of the metastatic group was lower than that of the non metastatic group,and the f value was higher than that of the non metastatic group(P＜0.05).There was no significant difference in ADC and D*values between the two groups(P＞0.05).In the DCE-MRI parameters,the Ktrans and Ve values in the metastatic group were higher than those in the non metastatic group(P＜0.05).There was no significant difference in Kep values between the two groups(P＞0.05).ROC curve showed that D,f Ktrans and Ve had moderate value in predicting lymph node metastasis of cervical cancer alone.The area under the curve(AUC)was 0.842,0.749,0.785 and 0.828,the specificity was 0.714,0.688,0.662 and 0.766,and the sensitivity was 0.846,0.731,0.846 and 0.731,respectively.The combination of various parameters had a high predictive value for cervical cancer lymph node metastasis,with an AUC of 0.959,a specificity of 0.883,and a sensitivity of 0.923.Conclusion The D,f,Ktrans,Ve and other parameters obtained from DCE-MRI and IVIM-DWI examinations are ideal indicators for predicting cervical cancer lymph node metastasis,and the combination of these parameters has higher predictive value for cervical cancer lymph node metastasis.
万方数据
维普
