【2017年整理】DWIBS在子宫卵巢恶性肿瘤方面应用价值.doc

DWIBS技术在子宫卵巢恶性肿瘤方面应用价值 黄泽春 冷渌清 蔡长寿 熊伟 王敏 胡苏兵 江西中寰医院影像科 330038 南昌 【摘要】 目的:探讨磁共振背景抑制弥散成像（diffusion weighted imaging with background suppression，DWIBS）技术在子宫卵巢恶性肿瘤方面的应用价值。方法：对临床确诊的14例子宫内膜癌， 32例宫颈癌，5例卵巢癌，1例阴道癌患者进行MRI常规及DWIBS检查，经3D容积与MIP重建，进行影像与临床对比分析。结果：根据FIGO外科分期，Ⅰ期25例、Ⅱ期15例、Ⅲ期10例、Ⅳ期7例、术后复发转移4例、术后正常1例。48例患者原发和转移病灶在DWIBS图像上表现为高亮或高信号，1例子宫内膜癌Ⅰa期、2例宫颈癌Ⅰa期及1例宫颈癌术后患者病灶在DWIBS图像上显示为正常。结论： 除子宫内膜癌及宫颈癌Ⅰa期病变外，结合MRI平扫与DWIBS图像能清楚显示病灶及其侵犯和转移情况，对子宫与卵巢病变的术前分期及疗效评估有较大的价值。 【关键词】 DWIBS; 子宫卵巢恶性肿瘤; 分期和疗效 [Abstract] Objective To search the valuation of diffusion weighted imaging with background suppression (DWIBS) in uteri and ovarian malign tumor. Methods 14 cases of endometrial carcinoma, 32 cases of cervical carcinoma, 5 cases of ovarian carcinoma and 1 cases of vaginal carcinoma confirmed by pathology were included. MRI general and DWIBS sequences were performed in all patients and images were reconstructed by 3D and MIP. Images were analyzed combined with clinic. Results According to the FIGO surgery stage, there are stageⅠ (25) ，stage Ⅱ (15) , stage Ⅲ (10) , stage Ⅳ (7) , postoperative recrudescence (4) and postoperative natural (1).The primary lesion and metastasis of 48 cases are high density or high signal on DWIBS images, while 1 case of stage Ⅰa with endometrial carcinoma and 2 cases of stage Ⅰa with cervical carcinoma and 1 case of postoperative recrudescence with cervical carcinoma were shown normally. Conclusion Exception stage Ⅰa of endometrial carcinoma and cervical carcinoma, combined with MRI general scan ,DWIBS imaging can show clearly the invaded degree of the lesion and the metastasis , especially the lymph nodes, DWIBS imaging is helpful in defining the stage before operation and in evaluating curative effect [Key word] DWIBS; uteri and ovarian malign tumor; the stage and effect 宫颈癌、子宫内膜癌及卵巢癌占妇女原发恶性肿瘤的第二位，由于现在医疗条件及设备的进展，对子宫及卵巢恶性肿瘤的早期诊断要求有明显提高，不仅仅对病变本身诊断，甚至全身有无转移提出更高要求。患者术前有无周围侵犯、远处转移直接影响临床治疗方案，正确的术前分期及可切除性评估、预后及疗效监测是减少不必要的手术创伤、提高治愈率、改善患者生活质量的重要因