| Objective To evaluate the clinical value of whole body diffusion weighed (WB- DWI) in staging of uterine cervical carcinoma.Methods From january 2007 to february 2009,26 patients were proved uterine cervical carcinoma by cervical biopsy received preoperative conventional MR and WB-DWI scan, and 30 heath volunteers received WB-DWI scan. Results of body DWI were compared with pathological findings. The apparent diffusion coefficient (ADC) values,DWI signal intensity(SI)of the normal uterine cervix and uterine cervical carcinoma were compared.ADC values , DWI SI, long/short axial ratio(LSR)of benign(normal/ inflammatory ) lymph nodes were also compared with that of metastatic ones.Results Twenty-six consecutive female patients with cervical cancer of the uterus (23 squamous cell carcinomas,1 adenocarcinoma, 1 adenosquamous and 1 small cell carcinoma), and We successfully obtained good image quality from all cases of WB- DWI. When was 800s/mm,the mean ADC value of uterine cervical carcinoma (n = 26)was(0.98±0.19)×10-3 mm2 /s , which was significantly lower than those of the 3 layers of normal uterine cervix [(1.60±0.22)×10-3 mm2 /s],[(1.78±0.25)×10-3 mm2 /s],[(1.86±0.23)×10-3 mm2 /s,P=0.00<0.05],there was no significant difference in ADC value between the intermedial and outer zone, the mean ADC value of inner zone was lower than that of the intermedial and outer zones. ROC of the ADC value used for differentiating the inner zone of normal uterine cervix from uterine cervical carcinoma, the AUC is 0.984. When an ADC values of 1.28×10-3 mm2 /s was used for threshold, the sensitiity as a diagnostic test was 96%(25/26), with specificity 100% (30/30);the accuracy was 98%(55/56);the positive predictive value was 100%(25/25);and the negative predictive value was 97%(30/31). Statistical analysis showed difference in SI of 3 layers of normal uterine cervix. The mean ADC value of metastatic nodes was(0.96±0.14)×10-3 mm2 /s, which was significantly lower than that of benign nodes(1.39±0.19)×10-3 mm2 /s(t=9.93, P=0.00 < 0.05 ) .Receiver operating characteristic(ROC) curve of the ADC value used for differentiating benign from metastatic nodes,the area under the curve (AUC) is 0.987.When an ADC values of 1.14×10-3 mm2 /s was used for threshold, The sensitiity as a diagnostic test was 83%(20/24), with specificity 98%(52/53); the accuracy 94%(72/77);the positive predictive value was 95%(20/21);and negative predictive value was 93%(52/56). The SI of metastatic nodes(216.65±52.80)were higher than benign nodes(163.01±52.43, t=4.21,P=0.00 <0.05). The LSR of metastatic nodes (1.43±0.31)showed no significant difference with benign nodes(1.51±0.30, P=0.30 >0.05).Conclusions WB-DWI scan can distinguish uterine cervical carcinoma from normal uterine cervix, and also could be used to distinguish metastatic nodes from benign nodes,WB-DWI scan is suggested for staging of uterine cervical carcinoma.
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