MRI评估宫颈癌宫旁侵犯和淋巴结转移的价值

Value of MRI in evaluating parametrial invasion and lymph node involvement of cervical carcinoma

目的探讨MR检查对子宫颈癌宫旁侵犯和盆腔淋巴结转移的诊断价值。方法对45例经病理组织检查证实的宫颈癌患者行术前MR检查,与手术病理诊断结果对照,采用诊断试验方法,以敏感度、特异度、准确性3项指标分析MRI判断宫颈癌宫旁侵犯和盆腔淋巴结转移的价值。结果MRI对宫旁侵犯的判断敏感度为80.0%,特异度为91.4%,准确性为88.9%;而临床分期对宫旁侵犯的判断敏感度为50.0%,特异度为82.9%,准确性为75.6%;MRI对盆腔淋巴结转移判断的敏感度为55.6%,特异度为94.4%,准确性为86.7%。结论①MR检查在判断宫颈癌宫旁侵犯方面优于临床分期;②MRI检查对诊断宫颈癌盆腔淋巴结转移的特异度较高,但敏感度低。

Objective To elucidate the usefulness of magnetic resonance imaging(MRI)for the detection of parametrial involvement and lymph node metastasis in patients with cervical cancer.Methods Forty-five patients with biopsy-confirmed cervical cancer who underwent preoperative MRI retrospectively recruited.We evaluated the diagnostic performance of MRI for the parametrial invasion and LN involvement using surgicopathologic findings as the reference standard.Results The sensitivity,specificity and accuracy of MRI in detecting parametrial invasion were 80.0%,91.4% and 88.9% respectively;while clinical examination were 50.0%,82.9% and 75.6% respectively.The sensitivity,specificity and accuracy of MRI in detecting LN involvement was 55.6%,94.4% and 86.7% respectively.Conclusion ①Preoperative MRI is more useful for the evaluation of parametrial involvement in cervical cancer than clinical examination.② Preoperative MRI shows high specificity,however,the sensitivity is low for detecting LN involvement in cervical cancer.Further studies are necessary to improve the sensitivity.