MRI对宫颈癌宫旁浸润的诊断价值

目的：探讨MRI在宫颈癌宫旁浸润中的临床应用价值。材料与方法连续入组58例经手术病理证实的宫颈癌患者，将术前磁共振成像检查结果与手术病理结果对照，评价T2WI、T2WI结合DWI、T2WI结合增强扫描、T2WI结合DWI及增强扫描四种不同的序列组合判断宫旁浸润的准确性。结果58例宫颈癌中有8例存在宫旁浸润，T2WI判断宫旁浸润的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为87.5%、90.0%、58.3%、97.8%、89.7%，T2WI结合DWI判断宫旁浸润的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为87.5%、96.0%、77.8%、98.0%、94.8%，T2WI结合增强扫描判断宫旁浸润的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为62.5%、100.0%、100.0%、94.3%、94.8%，T2WI结合DWI及增强扫描判断宫旁浸润的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为87.5%、100.0%、100.0%、98.0%、98.3%。结论磁共振成像T2WI结合DWI及增强扫描判断宫旁浸润的能力优于其他三种序列组合。

Value of magnetic resonance imaging in parametrial invasion of cervical cancer

Objective： To investigate the value of magnetic resonance imaging （MRI） in parametrial invasion of cervical cancer. Materials and Methods： Fifty-eight consecutive patients with histopathologically confirmed cervical cancer were collected. MRI ifndings were compared with the pathologic ifndings in all cases. The parametrial invasion was evaluated in the following four groups, T2 weighted imaging （T2WI）, T2WI combined with diffusion-weighted imaging （DWI）, T2WI combined with contrast enhancement and T2WI combined with DWI and contrast enhancement. Results：Among these 58 patients, 8 patients had parametrial invasion. The sensitivity, speciifcity, positive predictive value, negative predictive value and accuracy of T2WI were 87.5%, 90.0%, 58.3%, 97.8%, 89.7%. Those of T2WI combined with DWI were 87.5%, 96.0%, 77.8%, 98.0%, 94.8%. Those of T2WI combined with contrast enhancement were 62.5%, 100.0%, 100.0%, 94.3%, 94.8%. Those of T2WI combined with DWI and contrast enhancement were 87.5%, 100.0%, 100.0%, 98.0%, 98.3%. Conclusions：T2WI combined with DWI and contrast enhancement is superior to other three groups in the evaluation of parametrial invasion.