MRI在宫颈癌诊断中的应用
The Application of MRI in the Diagnosis of Cervical Cancer
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摘要: 目的:通过对较大样本宫颈病例的MRI表现进行比较,探讨不同种类宫颈肿瘤的MRI表现特征及其病理基础,从而评价MRI对宫颈良恶性病变的诊断价值。方法:随机选取在我院接受手术的宫颈肿瘤患者620例,共655个病灶。所有病例均行MR平扫,动态增强,扩散加权成像检查,探究宫颈恶性以及良性病变的分布情况;分析MRI对浸润性以及非浸润性宫颈癌诊断的敏感性和特异性;比较超声造影与MRI在诊断肿瘤大小、浸润深度、宫旁浸润、淋巴结转移以及临床分期的准确率。结果:通过MRI检查,可发现宫颈恶性病灶405个,良性病灶250个,其中良性病灶中位直径1.50cm,恶性病灶中位直径2.32cm;良性病变中位年龄40.42岁,恶性病变中位年龄46.57岁;宫颈MRI对于浸润性宫颈癌的敏感和特异性高于非浸润性宫颈癌(<i<P</i<<0.05);MRI在诊断宫旁浸润的准确率为92.3%,诊断淋巴结转移的准确率为93.4%,临床分期的准确率为95.2%,均高于超声造影准确率(<i<P</i<<0.05)。结论:宫颈MRI对于浸润性宫颈癌的敏感和特异性高于非浸润性宫颈癌(<i<P</i<<0.05);MRI在诊断宫旁浸润、淋巴结转移、临床分期的准确率明显高于超声造影(<i<P</i<<0.05)。研究表明MRI在宫颈癌诊断中起到了重要的作用,对MRI技术的熟练与改进有助于提高宫颈癌诊断的准确率。Abstract: Objective: To analyze the MRI performance of large sample cases of cervical patients and explore different histological types and classification of cervical tumor by MRI performance characteristics and their corresponding pathological histology and then evaluate the value of MRI in diagnose of cervical benign and malignant lesions. Methods: We randomly selected 620 cases of cervical cancer patients that were pathology confirmed and received surgery in our hospital, accounted for 655 lesions. All cases were performed MR scan, dynamic enhance, diffusion weighted imaging in order to explore the distribution of cervical malignant and benign lesions; Analyzed the diagnostic sensitivity and specificity of MR on invasive and non-invasive cervical cancer and made comparisons between contrast-enhanced ultrasonography and MRI in the diagnosis of tumor size infiltration depth Near the palace infiltration, lymph node metastasis and clinical staging accuracy. Results: There can be found 405 malignant cervical lesions and 250 benign cervical lesions. The benign lesions were in a diameter of 1.50 cm, malignant lesions were in a diameter of 2.32 cm; the benign lesions were in the median age of 40.42 years old and the malignant lesions were in the median age of 46.57 years old; The cervical MR effectiveness for the diagnosis of invasive cervical cancer(sensitivity and specificity) was higher than non-invasive cervical cancer(<i<P</i<<0.05); The accuracy of MRI in the diagnosis of palace next to the infiltration was 92.3%, the accuracy of MRI in the diagnosis of lymph node metastasis was 93.4%, the accuracy of MRI in the diagnosis of clinical stage was 95.2%, the accuracy of MRI were higher than ultrasound imaging accuracy(<i<P</i<<0.05). Conclusions: The MRI effectiveness for the diagnosis of invasive cervical cancer(sensitivity and specificity) was higher than non-invasive cervical cancer(<i<P</i<<0.05); the accuracy of MRI in the diagnosis of palace next to the infiltration, lymph node metastasis and clinical stage were higher than ultrasound imaging accuracy(<i<P</i<<0.05). Studies have shown that MRI played an important role in cervical cancer diagnosis, skilled and improvement of MRI techniques could improve the correct rate of diagnosing of cervical cancer.