磁共振检查在宫颈癌术前评估中的价值

目的 探讨磁共振检查(magnetic resonance imaging,MRI)在早中期宫颈癌术前评估中的价值.方法 选择2007年5月至2010年6月间我院收住的56例宫颈癌患者的术前MRI影像学及完整的临床病理资料,分别观察MRI中的肿瘤位置、大小、信号特征、浸润范围及盆腔淋巴结转移情况,并以术后病理为金标准,采用病例自身对照,结合患者的临床分期,分析宫颈癌的MRI影像学分期在宫颈癌临床分期和淋巴结转移中的预测价值.结果 56例宫颈癌中,有53例(占94.6%)MRI扫描见异常病灶.病灶在 T1WI像大多呈等信号,T2WI像呈高信号,DWI成像呈明显强化.MRI影像学分期中有49例(占87.5%)与术后病理分期吻合,明显高于临床分期的55.3%(P=0.000).MRI预测盆腔淋巴转移的灵敏度为61.5%,特异度为93.0%,准确度为85.7%.结论 MRI检查可判断宫颈肿块大小、肌层浸润深度,并可测量病灶与宫颈内口的距离,显示盆腔淋巴转移情况.MRI可常规应用于早中期宫颈癌患者的术前评估,以辅助提高临床分期的准确性.

The value of MR imaging in preoperative assessment in cervical cancer

Objective:To probe the value of magnetic resonance imaging(MRI) in preop-erative assessment in the early-middle stage of cervical cancer.Methods: A prospective study from May 2007 to June 2010 was carried out in 56 cases of cervical cancer patients who were admitted to our hospital while the preoperative MRI and clinicopathological information were collected completely.The tumor’s location,size,signal characteristics,infiltrating range and pelvic lymph node metastasis were observed from MRI,respectively.With postopera-tive pathologic as gold standard,cases as the self-reflection,combined with the patients clinical staging,we attempted to predict the value of MRI staging in exploring cervical cancer in clinical staging and lymph node metastasis.Results: In 56 cases of cervical cancer,abnormal lesions could be observed in 53 cases(94.6%) from MRI.The lesions present equisignal in T1-weighted imaging,high signal in T2-weighted imaging,and hyperintense in diffusion weighted imaging.A total of 49 cases(87.6%) of patients based on the MRI were correctly diagnosed according to the postoperative pathological staging,significantly higher than the results based on clinical staging 55.3%(P =0.000).The sensitivity,the specificity,the accuracy of the MRI prediction of pelvic lymph node metastases were 61.5%,93.0% and 85.7%,respectively.Conclusion: MRI examination can judge cervical tumor size,muscular layer infiltration depth,and can measure the distance from the superior border of the tumor to cervical internal os,can display pelvic lymph node metastases.MRI should be used routinely in the evaluation of preoperative in early-middle cervical cancer patients to improve the accuracy of the clinical staging auxiliary.