MRI在宫颈癌诊断与分期中的应用价值

The Value of MRI in the Diagnosis and Staging for Cervical Cancer

[目的]探讨MRI扫描在宫颈癌术前诊断、分期中的应用价值。[方法]回顾性分析67例宫颈癌患者的术前MRI平扫、动态增强表现,分析肿块影像特点,邻近组织受侵情况及远处脏器转移情况,对MRI分期、临床分期及术后病理分期进行对照。[结果]宫颈癌病灶在平扫T1WI上多呈等、低信号,在T2WI上多呈等信号或稍高信号,仅少数呈低信号,在T2WI(FS)上肿瘤呈稍高信号,仅少数呈低信号,增强扫描(VIBE)肿瘤呈明显中度(等同宫体强化)强化,部分病例轻度强化。MRI对宫颈癌的定位准确率为97.01%(65/67),分期总准确率为86.56%(58/67),临床分期总准确率为71.64%(48/67),MRI对宫颈癌的分期总准确率高于临床分期总准确率(χ2=5.786,P<0.05)。[结论]MRI对宫颈癌的定位及诊断准确率较高,可作为宫颈癌诊断的常规检查。术前分期中MRI较临床有明显优势,尤其对Ⅱb及以上期别病例,可作为中晚期宫颈癌术前评估的常规检查方法。

[Purpose] To evaluate the value of MRI in diagnosis and preoperative staging for cervical cancer. [Methods] Preoperative MRI scan and dynamic contrast-enhanced performance in 67 cases with cervical cancer were enrolled. Characteristics of lumps image,adjacent tissue invasion and distant organ metastasis were analyzed. MRI stage,clinical stage and pathological stage were compared. [Results]Most cervical cancer lesions in the unenhanced T1 WI showed equal or low signal,showed equal or slightly higher signal on T2 WI,only a few showed low signal. Tumors showed slightly higher signal on T2WI（FS）,only a few showed low signal.Enhanced scan（VIBE） tumors were sharp or moderate（equivalent uterus body enhanced） to strengthen,in some cases soft enhancement. Positioning accuracy rate of MRI for cervical cancer was 97.01%（65/67）. Overall accuracy rate of MRI stage was 86.56%（58/67）,and overall accuracy rate of clinical stage was 71.64%（48/67）（χ2=5.786,P〈0.05）. [Conclusion]MRI can accurately prompt,lesion size and organs involvement in cervical cancer to make more accurate decision. The MRI stage is superior to the clinical stage. MRI can be used as a routine examination for advanced cervical cancer.