术前CT和MRI检查对浸润性宫颈癌的诊断价值

Diagnostic significance of CT versus MRI for invasive cervical cancer

目的探讨术前CT和MRI对浸润性宫颈癌的临床诊断价值。方法选取2016年3月至2017年12月间辽宁省阜新市第二人民医院收治的61例浸润性宫颈癌患者。观察浸润性宫颈癌患者术前CT和MRI与浸润性宫颈癌患者术后病理结果比较情况,以及两种诊断方式对患者术前分期的符合率。结果CT在诊断子宫体侵犯和盆腔淋巴结转移与病理学结果的一致性高,Kappa值分别为0.871和0.850,在诊断阴道浸润的效果与病理学结果一致性较差,Kappa值为0.258;MRI在诊断阴道浸润、子宫体侵犯与病理学结果的一致性较好,Kappa值分别为0.796和0.654,在诊断盆腔淋巴结转移效果与病理学结果一致性较差,Kappa值为0.308。术前MRI在阴道浸润的敏感度和准确度均高于CT诊断,CT诊断子宫体侵犯的特异度和准确度,及CT诊断盆腔淋巴转移的特异度和转移准确度方面均高于术前MRI诊断,差异均有统计学意义(均P<0.05)。CT在宫颈癌A期的诊断符合率为52.4%,低于MRI的90.5%,差异有统计学意义(P<0.05)。但两者术前诊断方式在宫颈癌B期和C期的诊断符合率进行比较,差异无统计学意义(P>0.05)。结论在对于浸润性宫颈癌患者的术前诊断的准确度上,MRI要优于CT,且在病理分期上MRI诊断符合度要高于CT诊断,因此,MRI诊断具有更高的可靠性。但是在对浸润性宫颈癌患者进行术前分期的时候,不建议只采用一种诊断技术,建议MRI结合其他影像学诊断技术的术前诊断方式。

Objective To research the diagnostic significance of CT versus MRI for invasive cervical cancer.Methods Sixty-one patients with invasive cervical cancer receiving treatment at The Second Hospital of Fuxin/Fuxin Maternity Hospital were selected from March 2016 to December 2017.The results of CT and MRI diagnosis before the surgery were compared with the results of pathology tests after the surgery.The consistency rate of the two diagnostic approaches for preoperative staging was evaluated.Results The consistency between CT and pathology tests for uterus invasion and lymphatic metastases from pelvic tumors was high and Kappa value was 0.871 and 0.85,respectively.However,the consistency between CT and pathology tests for vaginal invasion was low and the Kappa value was 0.258.The consistency between MRI and pathology tests for vaginal invasion and uterus invasion was high and Kappa value was 0.796 and0.654.However,the consistency between MRI and pathology tests for lymphatic metastases from pelvic tumors was low and Kappa value was 0.308.The sensitivity and accuracy of MRI for vaginal invasion were higher than CT.On the contrary,sensitivity and accuracy of CT for uterus invasion and lymphatic metastases from pelvic tumors were higher than MRI(all P<0.05).The consistency rate was 52.4%for CT for stage A cervical cancer which was lower than 90.5%of MRI(P<0.05).However,there was no significant difference in consistency rate between the diagnosis methods for stage B and C cervical cancer before the surgery(P>0.05).Conclusion The accuracy of MRI was higher than CT for invasive cervical cancer before the surgery.For clinicopathological staging,the consistency of MRI was higher than CT.Therefore,MRI diagnosis has high reliability.However,for preoperative staging of invasive cervical cancer,it is suggested using MRI combined with other image techniques rather than only depending on single diagnostic technique.