MSCT与多平面重组诊断不同分期宫颈癌

目的探讨MSCT及MPR在宫颈癌诊断中的价值。方法回顾性分析125例宫颈癌患者的CT、临床、病理资料。全部患者均接受轴位平扫及增强扫描,并行冠状位及矢状位MPR。以FIGO及病理分期为对照比较CT轴位及MPR对宫颈癌术前分期的准确率。结果手术病理分期结果:原位癌3例,Ⅰa期41例,Ⅰb期36例,Ⅱa期34例,Ⅱb期6例,Ⅲa期2例,Ⅲb期1例,Ⅳ期2例。CT轴位扫描分期结果:原位癌及Ⅰa期0例,Ⅰb期9例,Ⅱa期12例,Ⅱb期4例,Ⅲ期3例,Ⅳ期2例。MPR对7例CT轴位未明确分期的Ⅰa期～Ⅱa期患者进行了准确分期。MPR图像与轴位扫描对Ⅰa～Ⅱa期的诊断准确率差异有统计学意义。结论 CT轴位扫描对早期宫颈癌的诊断准确率较低。MPR图像可以明显提高Ⅰa～Ⅱa期的诊断准确率,对判断Ⅱb期～Ⅳ期宫颈癌宫旁浸润、阴道受侵及远处转移有一定价值。

MSCT and MPR in diagnosis of cervical carcinoma in different stages

Objective To observe the value of MSCT and multiplanar reconstruction(MPR) in diagnosis and staging of cervical carcinoma.Methods Totally 125 patients of cervical carcinoma with clinical,pathylogical and CT data were retrospectively analyzed.All patients underwent plain and enhanced axis scans.The images were postprocessed with coronal and sagittal MPR.The accuracy of MSCT and MPR staging based on FIGO and pathology staging were compared.Results Pathology staging showed that carcinoma in situ in 3 cases,Ⅰa in 41,Ⅰb in 36 cases,Ⅱa in 34,Ⅱb in 6,Ⅲa in 2,Ⅲb in 1 and 2 in Ⅳ.CT staged no cases in situ norⅠa period,9 in Ⅰb,12 in Ⅱa,4 in Ⅱb,3 in Ⅲ and 2 in Ⅳ.MPR discovered 7 cases of Ⅰa—Ⅱa which were not found on axis CT.The diagnosis sensitivity and accuracy of Ⅰa—Ⅱa period cervical carcinoma were statistically different between MSCT and MPR.Conclusion The clinical value of axis MSCT for cervical cancer is limited.MPR can increase the diagnostic accuracy of CT forⅠa—Ⅱa cervical cancer.MPR images can improve the detection rate of Ⅱb—Ⅳ period of cervical cancer,and is valuable for judging parametrial invasion,lymphnode metastasis and distant metastasis.