›› 2020, Vol. 40 ›› Issue (2): 224-.doi: 10.3969/j.issn.1674-8115.2020.02.013

• Original article (Clinical research) • Previous Articles     Next Articles

Clinical value of IVIM MRI and DCE MRI in assessment of lymphovascular space invasion status in early cervical cancer

MI Hong-lan, CHENG Jie-jun, YIN Xia, ZHU Li, LIN Cong, LU Qing   

  1. 1. Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2. Department of Gynecology and Obstetrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2020-02-28 Published:2020-03-20
  • Supported by:
    Shanghai Pujiang Plan (15PJ1405200); Teaching Program of Shanghai Jiao Tong University School of Medicine (888.002.5039.02).

PDF (PC)

281

Abstract: Objective · To investigate the clinical value of intravoxel incoherent motion (IVIM) MRI and dynamic contrast enhancement (DCE) MRI in assessment of lymphovascular space invasion (LVSI) in early cervical cancer patients preoperatively. Methods · Fifty-six patients with early cervical cancer were collected, all of whom underwent preoperative IVIM and DCE MRI. The tumor maximum diameter, the depth ratio of cervical infiltration and the IVIM (f, D and D*) and DCE (Ktrans, Kep and Ve) MRI quantitative parameters were measured, respectively. According to postoperative pathological results, patients were divided into LVSI positive group and LVSI negative group. Patients age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathological type and differentiation degree were also recorded. The difference of basic characteristics and MRI parameters of the two groups was compared. Logistic regression was used to analyze the risk factors of LVSI in early cervical cancer, and the receiver operator characteristic curve (ROC curve) was applied to assess the diagnostic efficacy of these risk factors of LVSI. Results · There were no significant differences in patients age, FIGO stage, pathological type, differentiation degree and tumor maximum diameter between LVSI positive group and LVSI negative group. The depth ratio of cervical infiltration in LVSI positive group was significantly higher than that in LVSI negative group (P0.000), while D* value and Ktrans value in LVSI positive group were significantly lower than those in LVSI negative group (P0.003, P0.004). D value, f value, Kep value and Ve value showed no significant difference between the two groups. Logistic regression analysis showed that the depth ratio of cervical infiltration and Ktrans value were independently correlated with LVSI. The area under the curve AUC and the accuracy of independent diagnosis of LVSI state were 0.760 and 75.1%, 0.723 and 71.4%, respectively. The AUC of combined diagnosis was 0.839 and the accuracy was 76.8%. After the inclusion of D* value, the AUC of the three diagnosis was 0.874, with the accuracy of 87.5%. Conclusion · The depth ratio of cervical infiltration and Ktrans value are helpful for preoperative evaluation of LVSI status in early cervical cancer, and they can improve the diagnostic efficacy when combined with D* value.

Key words: cervical carcinoma, lymphovascular space invasion (LVSI), intravoxel incoherent motion (IVIM), dynamic contrast enhancement (DCE)