The Clinical Studies Of Functional Magnetic Resonance Imaging Which Diagnose And Evaluates Clinical Curative Effects In Cervical Carcinoma

Objective To evaluate the value of conventional magnetic resonance imaging combined with diffusion-weighted imaging(DWI)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) in diagnosis,staging and neoadjuvant chemotherapy of cervical carcinoma.Methods30cases cervical cancer and10cases normal cervical,10cases cervical cancer was surgical resection,and20cases cervical cancer received neoadjuvant chemotherapy,and all patients were pathologically confirmed.1、MRI imaging and analysis Using Siemens3.0T MRI scanner imaging, scanning sequences included sagittal T1WI, T2WI, T2WI-FS, horizontal position T2WI-FS, coronal T2WI-FS, DWI and DCE-MRI. After MRI scanning,the data was transmitted to the workstation (Siemens Verio),then analyzing lesions’ characteristics such as lesions sizes, internal signal,invasion range,lymph node,ADC value and TIC types.2、Pathological examination and analysis Operation group was performed pathological examination after surgery,and evaluating lesions invasion range(up and down,depth, parametrial and lymph node metastasis),and testing immunohistochemical expression of VEGF,nm23-H1.Statistical analysisThe data was analyzed by using SPSS18.0statistical analysis software.(1)cervical cancer tissue and normal tissue ADC values(ANOVA), TIC curve type (chi-square test);(2)ADC values before and after neoadjuvant chemotherapy (ANOVA), TIC curve type (chi-square test);(3)The correlation among VEGFn nm23-H1expressions and ADC、nm23-H1(ANOVA,chi-square test). Results1、The mean ADC value of cervical carcinoma was much lower than normal cervical tissue,there were respectively(0.891±0.10)x10-3mm2/s,(1.893±0.25)x10-3mm2/s.,and there were statistic differences between them.The average ADC value increased after chemotherapy comparing with before chemotherapy in cervical cancer,and there were respectively(0.90±0.10)x10-3mm2/s,(1.24±0.13) x10"3mm2/s,and the difference is statistically significant(P<0.05).2、Conventional MRI staging high in6cases, low staging in1case, conventional MRI combined with DWI、DCE-MRI staging high in3cases.Conventional MRI and conventional MRI combined with DWI、DCE-MRI misdiagnosis rate was23.3%(7/30),10%(3/30), staging accuracy rate was53.3%(16/30),83.3%(25/30).3、Cervical cancer TIC type I in17cases,type Ⅱ in13cases,normal cervical TIC type I in2cases,type IV in8cases,TIC type of cervical cancer and normal cervical each group were statistically significant. Cervical cancer before chemotherapy TIC type I in14cases,type Ⅱ in6cases,after chemotherapy TIC type I in2cases,type IV in12cases,type III in6cases,TIC types of cancer chemotherapy before and after type Ⅰ, type III was statistically differences.4、As cervical cancer pathology classification higher,the average ADC value decreases gradually,expression of VEGF、nm23H1increases. VEGF expression and ADC values without correlation;there exists positive correlation between expression of VEGF and TIC type.There were no correlation among expression of nm23-H1,ADC average value and TIC type.Conclusion1、Conventional MRI combined FMRI (DWI, DCE-MRI) compared to conventional MRI, it improves staging accuracy of cervical cancer, and it is important for clinical staging and treatment plan.2、Aside from DWI differentiate cervical cancer from normal cervical,it can also judge parametrial infiltration range and lymph node metastasis.;and ADC value can evaluate clinical effect of chemotherapy to some extent,and it can guide the subsequent treatment plan of development and adjustment.3、There has correlation between VEGF and TIC curve type;TIC curve type of cervical cancer is helpful to it’s diagnosis and differential diagnosis,and it can indirectly reflect tissue blood supply、 biological behavior and treatment response in cervical cancer.