MRI在子宫颈癌的诊断与分期中的应用价值

目的分析子宫颈癌的MR影像表现，并评价其诊断价值。方法74例经病理确诊的子宫颈癌患者于手术前均经盆腔轴位T1WI，T2WI，SPIR，矢状位T1WI，T2WI，增强扫描轴位及矢状位抑脂T1WI。根据肿瘤的位置、大小、信号特征、浸润范围、以及宫旁和盆壁的受累情况，将MRI所见进行影像学分期，并与国际妇产科联合会（FIGO）的分期结果相比较。结果子宫颈癌病变在末增强的T1WI上呈等信号，在T2WI上呈等信号或稍高信号，在T2WI上肿瘤与低信号的子宫颈基质和高信号的子宫颈内膜及子宫旁脂肪具有良好的对比，SPIR上肿瘤呈稍高信号，增强扫描肿瘤呈轻度强化或不明显强化，3D-动态MRI增强扫描肿瘤明显强化。MRI对子宫颈癌的定位诊断准确性为100％，分期准确性为91．88％。结论MRI具有很高的解剖分辨率，特别是采用3D-动态增强扫描，可为子宫颈癌的诊断与分期提供直接的解剖基础和客观依据。

Applied value of MRI in the diagnosis and staging of cervical carcinoma

Objective To analyze the MRI findings of cervical carcinoma and to assess their value for diagnosing this disease.Methods Seventy-four patients with pathologically proved cervical carcinoma underwent pelvic axial T1W1,T2WI,SPIR,sagittal T1WI,T2WI,and contrast-enhanced axial and sagittal SPIR T1WI exmaintions before the operation.MR imaging staging was carried out based on the tumor site,size,signal feature,invasive extent,parauterine and pelvic wall involvement and compared with postoperative International Federation of Gynecology and Obstetrics （FIGO） staging system. Results The tumor lesions were isointensity on non-enhanced T1WI and isointensity or slight hyperintensity on T2WI.There was excellent contrast between tumor lesions and hypointense cervical matrices,hyperintense endometria, and parauterine fat on T2WI, while on SPIR images ,the lesions were slightly or non-obviously enhanced.Following 3D-dynamic enhanced scans,the lesions were obviously enhanced.The accuracy of MRI for localizing and staging of cervical carcinoma was 100%and 91.88%,respectively. Conclusion MRI has highly anatomic resolution,espeeially 3D-dynamic enhanced scanning can provide direct anatomic basis and objective evidence in the diagnosis and staging of cervical carcinoma.