核磁共振联合阴道彩超评估早期子宫颈癌病情的价值初探

Preliminarily discuss the value of magnetic resonance imaging combined transvaginal ultrasonography for evaluating the patient with early-stage cervical cancer

目的:探讨核磁共振成像(MRI)联合阴道彩色多普勒超声(TVUS)预测早期宫颈癌预后高危因素的价值。方法:选择2008年9月至2013年1月在北京大学人民医院住院的临床分期为ⅠB和ⅡA期、术前未接受其他治疗并具有完整影像学检查资料的78例患者,患者术前均行核磁共振常规及加权成像(MRI+DWI)和TVUS检查,回顾分析影像学检查结果与术后病理的关系。结果:MRI、TVUS、MRI联合TVUS判断肿瘤直径、阴道浸润、宫旁组织受侵及淋巴结转移与术后病理的一致性均较高,均无统计学差异(P均≥0.05);判断宫颈间质浸润深度与术后病理的一致性较低,具有统计学差异(MRI组:P=0.007;TVUS组:P=0.010;MRI联合TVUS组:P=0.002);预测肿瘤直径、宫颈间质浸润、阴道浸润、宫旁浸润、淋巴结受累中的准确率:MRI分别为81.8%、73.7%、84.6%、94.9%、78.2%;TVUS分别为66.7%、51.3%、78.2%、96.1%、82.0%;MRI联合TVUS分别为84.4%、78.2%、89.7%、97.4%、92.3%。结论:术前MRI联合TVUS检查对预测早期宫颈癌可能出现的影响预后的高危因素有重要价值,可提高术前病情评估的准确度,为选择最佳治疗方案提供参考。

Objective：To discuss the predictive value of magnetic resonance imaging （ MRI） combined with transvaginal ultrasonography （ TVUS） for the high-risk factors of progno-sis for early-stage cervical cancer. Methods：Choosing seventy-eight patients of cervical cancer in Peking University People＆#39;s Hospital between Sep. 2008 and Jan. 2013,whose clinical stage were for ⅠB and ⅡA . All patients were performed with magnetic resonance imaging （ MRI ） with diffusion weighted imaging （ DWI ） and transvaginal ultrasonography in combination with colour doppler （ TVUS） preoperation,and we retrospectively analyzed the relationship between imaging results and the postoperative pathological findings. Results：There was no significant difference between MRI,TVUS and MRI combined TVUS for the judgment of tumor diameter, vaginal invasion,parametrial invasion and lymph node metastases （P≥0. 05）. However,there was statistical difference between cervical stromal invasion and imgine results （ MRI group P=0 . 007;TVUS group P=0 . 010;MRI plus TVUS group P=0 . 002 ） . For predicting diameter of tumor,stromal invasion,vaginal invasion,parametrial invasion and lymph node metastases,the accuracy rate of MRI was 81. 8%,73. 7%,84. 6%,94. 9%,78. 2%,and that of TVUS were 66. 7%,51. 3%,78. 2%,96. 1%,82. 0%,respectively. As analyzed MRI combined TVUS,the accuracy rates were increased（84. 4%,78. 2%,89. 7%,97. 4%,92. 3%,respectively）. Con-clusion：MRI combined TVUS have key value for predicting high-risk factors of patient with early cervical cancer preoperation. which can enhance the accuracy of preoperative condition as-sessment,and provide a reference for select the best treatment plan.