宫颈癌的MRI表现及分期判断

MRI Features and Staging of Cervical Carcinoma

目的 探讨宫颈癌的MRI表现及分期 ,并评价MRI对宫颈癌的临床价值。材料与方法 回顾性分析 5 6例宫颈癌患者MRI分期。所有患者均行轴位T1WISE ,轴位及矢状T2 WITSE ,冠状SPIR ,以及Gd DTPA增强后的三维扫描。结果 ( 1)在T2 WI中 ,宫颈癌肿瘤组织通常呈不均匀中等信号 ,与正常宫颈组织 (低信号 )及宫旁结构 (明显高信号 )之间具有良好的对比噪声比(CNR) ,对判断肿瘤大小及侵犯范围价值最大。 ( 2 )宫颈癌多向宫旁侵犯 ,而较少向阴道侵犯 ,5 6例MRI分期分别为Ⅰb 2例 ,Ⅱa 2例 ,Ⅱb 32例 ,Ⅲa 2例 ,Ⅲb 7例 ,Ⅳa 9例 ,Ⅳb 2例。结论 MRI可清晰显示宫颈癌肿瘤的侵犯范围 (尤其是有无宫旁侵犯 ) ,分期客观准确 ,对临床制订治疗方案及预后评估有重要意义 ,并且是无放射性检查方法 。

Objective To study MRI features and staging of cervical carcinoma, and to evaluate MRI in the diagnosis and clinical management of cervical carcinoma. Materials and Methods MRI findings and staging in 56 patients with cervical carcinoma were retrospectively analyzed. MRI scanning performed in all patients included axial T 1WI SE, axial and sagittal T 2WI TSE, coronal SPIR and Gd DTPA enhanced 3D scanning.Results (1) On T 2WI, the tumor showed heterogeneous moderate intensity signal with an excellent contrast-noise ratio (CNR), which enabled to judge the size and extension of the tumor. (2) Parametrial involvement was a common finding while vaginal involvement was not common. Based on MRI staging, stage ⅠB was seen in 2 cases, ⅡA in 2, ⅡB in 32, ⅢA in 2, ⅢB in 7, IVA in 9 and IVB in 2.Conclusion MRI can well demonstrate the size and extension, especially the parametrial involvement, of the cervical carcinoma. MRI is very helpful in the staging of the disease and in making the therapeutic plan. It is suggested that MRI should be regarded as a conventional study for the patients with cervical carcinoma.