부산대학교 도서관

PURPOSE. This study employed diffusion-weighted magnetic resonance (MR) imaging to distinguish the histological types and cell differentiation grades of cervical cancers though volumetric measurements of an apparent diffusion coefficient (ADC). MATERIALS AND METHODS. A total of 41 consecutive female patients (mean age = 49 ± 10 years) with newly diagnosed, biopsy-proven cervical cancers were enrolled in this study. Tumor differentiation grades and histological types including squamous cell carcinomas, adenosquamous carcinomas, and adenocarcinoma were recorded. Diffusion-weighted imaging was performed using a 3-Tesla MR system to obtain volumetric ADC values for each tumor calculated using b-factors of 0 and 1,000 s/mm^2 . Furthermore, the mean, minimum, median, maximum, kurtosis, skewness, 10th, 25th, 75th, and 90th percentile ADCs (ADC_(mean), ADC_(minimum), ADC_(median), ADC_(maximum), ADC_(kurtosis), ADC_(skewness), ADC_(10), ADC_(25), ADC_(75), and ADC_(90), respectively) of the whole tumor histogram were calculated. Statistical significance was calculated through the Wilcoxon rank sum test and Kruskal-Wallis test, and a p value ＜ 0.05 was considered significant. RESULTS. The ADC_(mean) values were significantly different among squamous cell carcinomas, adenosquamous carcinomas, and adenocarcinomas (0.91 × 10^(-3) mm^2 /s vs. 0.90 × 10^(-3) mm^2 /s vs. 1.15 × 10^(-3) mm^2 /s, p = 0.002). The ADC_(10) and ADC_(25) values were significantly different among tumors with low, intermediate, and high grades (0.91 × 10^(-3) mm^2 /s vs. 0.85 × 10^(-3) mm^2 /s vs. 0.72 × 10^(-3) mm^2 /s, p = 0.035). CONCLUSION. Volumetric mean ADCs are effective for distinguishing histological types and tumor differentiation grades of cervical cancer.