宫颈癌CT灌注成像分期与FIGO分期及病理分期的对照分析

目的研究宫颈癌CT灌注成像分期与FIGO分期及病理分期的比较。方法采用GE Lightspeed UItra 16排多层螺旋CT扫描仪对我院148例宫颈癌患者进行增强扫描,图像传输至PACE系统并进行多平面重建(MPR),得到冠状位、矢状位、斜冠状位图像,比较CT分期、FIGO分期及术后病理分期的差异。结果148例宫颈癌患者CT分期诊断Ⅰa期27例、Ⅰb期41例、Ⅱa期28例、Ⅱb期18例、Ⅲa期6例,分期正确120例,占81.08%,其中7例CT、FIGO分期显示无病变,漏诊率4.73%,后经术后脱落细胞学检出,CT诊断过低分期8例,占5.41%,过高分期20例,占13.51%,FIGO分期过低分期31例,过高分期28例,诊断准确率60.14%。结论 CT灌注成像分期准确率高于FIGO分期,并可提供更多的病理信息,可作为FIGO分期后的纠错检查措施,CT对术前分期、手术方案选择及预后有重要的指导意义。

Contrast Analysis of CT Perfusion Imaging Staging and FIGO Staging and Pathological Staging of Cervical Carcinoma

Objective To compare CT perfusion imaging staging and FIGO staging and pathological staging of cervical carcinoma.Methods 148 patients with cervical carcinoma were scanned with GE Lightspeed Ultra 16 slice spiral CT scanner.The images were transmitted to the PACE system and were processed by multi planar reconstruction (MPR) to obtain coronal,sagittal and oblique coronal images.The differences of CT staging,FIGO staging and postoperative pathological staging were compared.Results CT staging diagnosis of 148 patients with cervical carcinoma showed 27 cases of stage Ⅰ a,41 cases of stage Ⅰ b,28 cases of stage Ⅱ a,18 cases of stage Ⅱ b and 6 cases of stageⅢa.Staging was correct in 120 cases,accounting for 81.08％,in which CT and FIGO staging showing no lesions in7 cases.The rate of missed diagnosis was 4.73％ which was detected by postoperative exfoliative cytology.CT diagnosed excessive low staging in 8 cases,accounting for 5.41％ and excessive high staging in 20 cases,accounting for 13.51％.For FIGO staging,there was excessive low staging in 31 cases and excessive high staging in 28 cases.The diagnostic accuracy was 60.14％.Conclusion The accurate rate ofCT perfusion imaging staging is higher than that of FIGO staging and it can provide more infommation.It can be used as an error correction test after FIGO staging.CT is of important guiding significance in preoperative staging,the selection of operation scheme and prognosis.