MR动态增强扫描对早期宫颈癌的诊断及分期价值的研究

Evaluation of Dynamic Contrast-Enhanced MR Scanning in Making Preoperative Diagnosis and Staging of Cervical Carcinomas

目的研究MR动态增强扫描在ⅠB～ⅡB期宫颈癌术前分期中的作用。方法对在本院行MR平扫及动态增强扫描后行手术治疗的42例宫颈癌患者MR资料,双盲法进行术前分期,再结合动态增强扫描,绘制时间-信号曲线,并结合病理分期,计算分期的准确率,应用McNemar配对卡方检验统计两者准确率的差异性。结果平扫结合增强图像的术前MR分期准确率为66.7%,常规MR结合动态增强扫描后准确率提高到88%,两者之间的差异具有统计学意义（P=0.035）。结论 MR动态增强扫描早期时相,可以评价早期宫颈癌的浸润范围和宫旁、阴道侵犯程度,提高术前分期的准确性。

Objective To investigate the usefulness of dynamic contrast enhanced MR imaging （DCE-MRI） in preop- eratively staging I B - ⅡB uterine cervical carcinoma （UCC）. Methods A total of 42 patients with pathologically-con- firmed UCC were enrolled in this study. Both preoperative plain and dynamic contrast-enhanced MRI were performed in all the patients. Preoperative staging of the tumor was determined by using double blind method, then with the help of dynamic contrast-enhanced MRI scanning the time intensity curves （TIC） of region of interest （ROI） in pathological region and nor- mal tissue were drawn. Combined with the pathologic staging results, the accurate rate of tumor staging judged by DCE- MRI was calculated, and the differences in the accurate rate between pathology and DCE-MRI were statistically analyzed by using McNemar paired t test. Results The preoperative MR staging accuracy determined by plain and pre-contrast MR images was 66.7%, while the preoperative MR staging accuracy determined by routine MR and post-contrast MR images was 88.0%. The difference between the two techniques was statistically significant （P 〈 0.05）. Conclusion DCE-MR can effectively evaluate the invasion extent and the severity of parauterine and vaginal infiltration of early cervical carcino- ma, thus the preoperative staging accuracy can be improved.