MRI在宫颈癌诊断及分期中的应用价值

目的探讨磁共振成像(MRI)在宫颈癌诊断及分期中的应用价值。方法回顾性分析2014年8月至2015年12月因疑似宫颈病变于该院初诊并接受盆腔MRI检查的患者97例,分析MRI图像及临床资料。以病理学检查结果为金标准,计算MRI诊断宫颈癌的准确度、特异度及灵敏度。采用国际妇产科学会(FIGO)制定的分期标准,对MRI检查诊断为宫颈癌的真阳性患者进行MRI分期,并与临床分期进行比较。结果 MRI诊断宫颈癌79例,非宫颈癌18例。以病理学检查结果为金标准,MRI诊断假阴性5例,假阳性3例,诊断符合率为91.75%,灵敏度为93.83%,特异度为81.25%。真阳性患者总的MRI分期和临床分期比较,以及MRI分期为ⅡA1、ⅡA2、ⅡB、ⅢA和ⅢB期的患者例数与临床分期同期比较,差异无统计学意义(P0.05),但MRI分期为ⅠB1、ⅠB2、ⅡA1和ⅡA2期的患者例数与临床分期同期比较差异有统计学意义(P0.05)。结论 MRI对宫颈癌具有较高的诊断符合率、灵敏度及特异度,对病灶大小及宫颈癌浸润等的判断具有特殊优势,是判断宫颈癌分期的可靠方法。

Clinical value of MRI in cervical cancer diagnosis and staging

Objective To study the application of magnetic resonance imaging (MRI) in the diagnosis and staging of cervical cancer .Methods A retrospective analysis was performed on MRI images clinical data of 97 patients ,undergoing pelvic MRI exami‐nation from Aug .2014 to Dec .2015 ,who were suspected of cervical cancer .Diagnostic accuracy ,specificity and sensitivity of MRI on cervical cancer were analyzed ,taking pathological results as golden standard .The true‐positive cases of cervical cancer ,diagnosed by MRI ,were staged according to the International Federation of Gynecology and Obstetrics(FIGO) staging standards and compared with clinical staging .Results Among all patients ,79 positive cases and 18 negative cases were diagnosed by MRI .According to the golden standard of pathological results ,there were 5 false‐negative cases and 3 false‐positive cases .The diagnostic accuracy rate of MRI was 91 .75% ,with 93 .83% of sensitivity and 81 .25% of specificity .There were no significant difference between the overall of clinical and MRI staging ,and no significant difference in ⅡA1 ,ⅡA2 ,ⅡB ,ⅢA and ⅢB staging of MRI and clinical staging(P>0 .05) in true‐positive cases ,but there were significant difference in ⅠB1 ,ⅠB2 ,Ⅱ A1 and Ⅱ A2 staging of MRI ,compared with clinical staging(P<0 .05) .Conclusion MRI might be with high accuracy ,sensitivity and specificity in diagnosis of cervical cancer , also with special advantage for the judgement of tumor size and invasion ,which could be used as a reliable method in staging of cer‐vical cancer .