宫颈癌MRI分期与妇科检查分期对比分析

目的 对照妇科检查分期,探讨MRI在宫颈癌尤其是中、晚期宫颈癌分期中的价值。方法 32例具有完整临床及手术病理资料的宫颈癌患者,术前均行MRI检查,将MRI影像分期结果,临床妇科检查分期结果与宫颈癌术后病理分期结果相比较。结果 32例宫颈癌中,MRI分期判断为Iib期以前11例,Iib期（含Iib期）以后21例。与病理结果比较,MRI对二者区分的准确性为93%,对有无宫旁侵犯判断的准确性为94%,敏感性为91%,特异性为94%。妇科检查分期判断为Iib期以前14例,Iib期（含Iib期）以后18例。妇科检查对二者区分的准确性为87%,对有无宫旁侵犯判断的准确性为81%,敏感性为75%,特异性为87%。结论 MRI对早期宫颈癌的诊断及分期尚待改进,但对中晚期宫颈癌及宫颈癌宫旁侵犯,MRI具有重要临床应用价值。

Comparative study of magnetic resonance imaging staging with gynecological examination staging of cervical carcinoma

Objective To explore the value of magnetic resonance imaging（MRI）examination for determining the stage of advanced cervical cancer.Methods 32 patients with cervical cancer underwent MRI scanning,which had complete clinical and pathology records.Results of tumor staging based on MRI image analysis,clinical evaluation and postoperative pathological examination were compared.Results Based on MRI images,11 cases were classified as before stage IIb,21 cases were post-stage IIb（contain stage IIb）.The accuracy of MRI diagnosis and staging was 93%respectively,the accuracy of parauterine tissue invasion was 94%,the sensitiveness was 91%,the specificity were 94%.MRI staging in all patients was compared with that of postoperative pathology.Based on gynecologic examination,14 cases were classified as before stage IIb,18 cases were post-stage IIb（contain stage IIb）.The accuracy of gynecologic examination diagnosis and staging was 87%respectively,the accuracy of parauterine tissue invasion was 81%,the sensitiveness was 75%,the specificity was 87%.Gynecologic examination in all patients was compared with that of postoperative pathology.ConclusionMRI examination of cervical cancer has a low accuracy of early staging,but it is a high accuracy of advanced staging and parauterine tissue invasion.