影像学检查在宫颈癌盆腹腔淋巴结转移诊断中的价值

2018年国际妇产科联盟（International Federation of Gynecology and Obstetrics,FIGO）更新宫颈癌分期,将治疗前影像学诊断盆腔淋巴结转移定义为ⅢC1r期,腹主动脉旁淋巴结转移定义为ⅢC2r期。术前影像学检查评估盆腹腔淋巴结是否转移与诊疗方案的制定相关,影像学准确地判断盆腹腔淋巴结状态可以明确分期,让患者接受规范的诊疗。目前临床上影像学检查方法众多,常用检查有B超、盆腔磁共振成像（magnetic resonance imaging,MRI）、计算机体层摄影术（computed tomography,CT）、正电子发射体层摄影术（positron emission tomography,PET）/CT及PET/MRI。B超经济方便,但对淋巴结检出率过低;CT在国内使用广泛、检查速度快,扫描范围大,临床应用易于推广,但CT诊断缺乏统一的诊断标准,诊断价值不突出;MRI具有良好的组织分辨率、能同时实现功能成像,但存在检查敏感度不高的情况;PET检查准确性较其他影像学检查较高,但其敏感度较MRI及CT检查并无统计学上的差异。

The Value of Imaging in the Diagnosis of Pelvic and Abdominal Lymph Node Metastasis in Cervical Cancer

In 2018, the International Federation of Gynecology and Obstetrics (FIGO) updated cervical cancer staging, defining pre-treatment imaging diagnosis of pelvic lymph node metastasis as stage ⅢC1r and paraaortic lymph node metastasis as stage ⅢC2r. Preoperative imaging assessment of pelvic and abdominal lymph node metastasis is related to the formulation of treatment plans, and accurate imaging judgment of pelvic and abdominal lymph node status can clarify the stage and allow patients to receive standardized treatment. There are many imaging methods in clinical practice, including ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET)/CT and PET/MRI. Ultrasound is economical and convenient, but the detection rate of lymph nodes is too low. CT is widely used, with fast examination speed and large scanning range, which makes clinical application easy to promote, but the lack of uniform diagnostic criteria for CT diagnosis makes the diagnostic value not outstanding. MRI has good tissue resolution and can realize functional imaging at the same time, but the sensitivity of examination is not high. The accuracy of PET examination is higher than other imaging examinations, but its sensitivity is not statistically different from that of MRI and CT examination.