MRI在早期宫颈癌间质浸润深度判定中的价值

目的 探讨MRI 对早期宫颈癌间质浸润深度测量的准确性。方法 回顾性分析66例早期宫颈癌患者的术前MRI资料。在MRI图像上测量宫颈间质浸润的最大深度，并将病灶分为浸润型和腔内生长型。两名医生测量结果之间的一致性、MRI测量值与病理测量值之间的一致性使用Bland-Altman图和组内相关系数ICC（intra-class correlation coefficient）来评价。不同生长方式的宫颈癌间质浸润最大深度测量的准确性和差异比较使用单因素方差分析，两两比较使用bonferroni法校正P值。结果 T2WI、T1增强和DWI测量宫颈间质浸润的最大深度与病理结果的一致性均为中等。对于不同生长方式的宫颈癌，MRI与病理测量值的一致性存在显著差异。对于浸润型肿瘤，MRI与病理测量一致性为很好或中等；对于腔内生长型的肿瘤，MRI与病理测量一致性较差。结论 MRI对早期宫颈癌间质浸润深度测量的准确性较好，其中浸润型肿瘤测量准确性优于腔内生长型。

Pre-operative MRI evaluation of stromal invasion in early stage cervical cancer patients

Objective This study compared the MRI measurement of maximum stromal invasion with the pathological results. Methods The preoperative MR imaging of 66 early cervical cancer patients were retrospectively analyzed. The maximum stromal invasion was measured on MR imaging, and all cases were classified into following two types: infiltration tumor and intraluminal growth tumor. Interobserver consistency analysis and the consistency between the measurements of MRI and pathological results were evaluated by Bland-Altman plot and the intraclass correlation coefficient (ICC). The accuracy and difference of maximum stromal invasion with different growth patterns were compared using one-way analysis of variance, and the bonferroni method was used to correct the P value. Results The measurement on T2WI, T1-CE and DWI was consistent with the pathological results. In terms of different growth pattern, there was a significant difference between the measurements of MRI and pathological results. For infiltration tumor, the measurement of MRI had a superior consistent with pathological results than that of intraluminal growth tumors, particularly for deep infiltration tumor. Conclusion The preoperative MR imaging has a good accuracy in measuring the depth maximum stromal invasion of early cervical cancer. In terms of reliability of measurement, infiltration tumor is superior to intraluminal growth tumor.