DCE-MRI联合IVIM-DWI预测早期宫颈癌盆腔淋巴结转移的价值OA北大核心CSTPCD

Objective:To investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in predicting pelvic lymph node metastasis(PLNM)of early cervical cancer.Materials and Methods:Imaging and clinical data from 124 patients with FIGO ⅠB-ⅡA cervical cancer confirmed by pathology were retrospectively analyzed.The quantitative parameters obtained from DCE-MRI and IVIM-DWI of the primary tumor between the PLNM group and non-PLNM group were compared.Multivariate logistic analysis was used to determine the independent risk factors,and receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic performance of all parameters.Results:The volume transfer constant(Ktrans;t=6.203,P<0.001),perfusion fraction(f;t=3.944,P<0.001),apparent diffusion coefficient(ADC;Z=4.393,P<0.001)and extravascular extracellular volume fraction(Ve;Z=2.312,P=0.021)in the PLNM group were significantly lower than those in the non-PLNM group.Multivariate analysis showed that Ktrans(P<0.001),f(P=0.003)and ADC(P=0.031)were the independent risk factors of PLNM in cervical cancer.The ROC curves showed that the area under curve(AUC)of Ktrans,f,and ADC for predicting PLNM were 0.808,0.707 and 0.745,respectively.Compared with individual parameter,the combination of the three parameters achieved the highest diagnostic efficacy to predict PLNM with an AUC of 0.893,the sensitivity and specificity were 82.4%and 86.8%,respectively.Conclusions:Ktrans,Ve from DCE-MRI,f and ADC from IVIM-DWI of primary tumor are helpful in evaluating PLNM of early cervical cancer.The three independent risk factors of Ktrans,f,ADC have high predicting value,and their combination can further improve diagnostic efficiency.