子宫颈癌术前磁共振成像诊断与术后病理分期对比分析

Comparasion analysis of MRI diagnosis value before surgery and pathology staging after surgery in uterine cervical carcinoma

目的探讨磁共振成像（MRI）术前分期的准确性与病理分期的准确性，以及对子宫颈癌治疗方式的指导价值。方法回顾性分析50例子宫颈癌患者（鳞癌47例，腺癌2例，腺鳞癌1例）的临床及MRI资料。所有患者行平扫及增强扫描，23例行三期动态增强扫描。38例经手术治疗的患者，对术前MRl分期与术式的选择及术后病理分期进行对照分析。结果33例MRl分期为I～ⅡA期的子宫颈癌准确率约为82．35％，患者行子宫全切术及盆腔淋巴结清扫术。ⅢA～ⅣB期的诊断准确率约100％。MRI对子宫颈癌分期总的准确率为84．21％。结论MRI能多方位显示子宫颈癌病灶及其侵犯范围，术前分期具有较高的准确性，有利于术前评估、手术方式的制定及治疗方案的选择。

Objective To discuss the value of MRI in the assessment of diagnosis and staging of cervical carcinoma. To compare MRI diagnosis value before surgery and pathology staging after surgery in uterine cervical carcinoma. Methods Pelvic MRI were performed in 50 patients with cervical carcinoma. The pathological type included 47 cases of squamous cell carcinoma, 2 cases of adenocarcinoma and 1 cases adeno-squamous carcinoma. The MRI scanning included axial SE T^WI, axial , sagittal and coronal FSE T2WI , and axial, sagittal and coronal enhanced or dynamic contrast-enhanced MR. MR staging were compared with surgical pathologic staging after surgery in 38 patients. Results The accuracy of MR imaging in stage I - 11 A of cervical cancer were 82.35 %. These patients performed an operation of hysterectomy or subtotal hysterectomy surgery. The accuracy of MR imaging in stage mA-IVB were 100 %. The accuracy of MRI in total stage were 84.21%. Conclusion MR imaging can show the local tumors and extension of the cervical cancer clearly on multiple planes and angles. Preoperative staging with high accuracy, MRI is conducive to preoperative evaluation, surgical plan formulation and selection.