CT和MRI在宫颈癌诊断与分期上的对比研究

A comparative study on MRI and CT in diagnosis and staging of cervical carcinoma

目的探讨MRI和CT检查对宫颈癌诊断和分期的价值。方法回顾性分析我院经病理确诊并行MRI或CT检查的宫颈癌患者42例,其中MRI检查22例,CT检查患者20例,在CT和MRI图像上根据原发肿瘤的大小、位置、影像特征及宫旁和盆壁侵犯情况进行分期,并与临床FIGO分期结果相比较。结果在治疗前进行盆腔CT检查的20例宫颈癌患者中,CT诊断≤ⅡA期为5例,临床诊断7例,低估2例;ⅡB期患者CT诊断6例,临床诊断5例,高估1例;Ⅲ期以上患者CT诊断6例,临床诊断8例,低估2例。20例患者中CT检查发现盆腔淋巴结肿大者15例。在治疗前进行盆腔MRI检查的22例宫颈癌患者中,MRI诊断Ⅰ期为4例,临床诊断2例,高估2例;Ⅱ期患者MRI诊断14例,临床诊断12例,高估2例;Ⅲ期以上患者MRI诊断6例,临床诊断8例,低估2例。22例患者中MRI检查发现盆腔淋巴结肿大者14例。结论宫颈癌临床分期现仍存在不足,需进一步地完善和改进。由于MRI的成像特点,在判断宫颈癌的分期方面较CT存在明显优势。

Objective To evaluate the value of MRI and CT in diagnosis and staging of uterine cervical carcinoma. Methods Pelvic MRI or CT imaging was performed in 42 patients with cervical carcinoma proved by pathology （ MRI was performed in 22 patients and CT was performed in 20 patients）. MRI and CT images were analyzed for location, signal characteristics, and extension of the primary tumor. The MRI and CT staging were compared with the clinical staging. Results There are 5 cases≤ ⅡA stage among 20 patients with CT imaging, but 7 cases≤ Ⅱ A stage with FIGO stage, 2 cases underestimated. 6 cases are IIB stage among 20 patients with CT imaging, but 5 cases with FIGO stage, 1 cases overrated. 6 cases ≥Ⅲ stage among 20 patients with CT imaging, but 8 cases with FIGO stage, 2 cases underestimated. There are 15 cases lymph nodes enlargement among 20 patients with CT imaging. 4 cases are Ⅰ stage among 22 patients with MRI imaging, but 2 cases are Ⅰstage with FIGO stage, 2 cases overrated. 14 cases are Ⅱstage among 22 patients with MR imaging, but 12 cases with FIGO stage, 2 cases overrated. 6 cases ≥Ⅲ stage with MRI imaging, but 8 cases with FIGO stage, 2 cases underestimated. There are 14 cases lymph nodes enlargement among 22 patients with MRI imaging. Conclusion It still has appeared some insufficiencies in the clinical staging. Further improving and perfecting should be carried out in it. MRI imaging is superior to clinical evaluation and CT image in the staging of uterine cervical carcinoma and should be regarded as a routine preoperative imaging study for cervical carcinoma.