CT诊断早期宫颈癌淋巴结转移的价值

The value of CT in diagnosing lymph node metastasis of early-stage cervical carcinoma

目的:探讨CT诊断早期宫颈癌患者淋巴结转移的价值。方法:回顾性分析78例宫颈癌患者的术前CT资料,分别从淋巴结大小、形态、强化、分布4方面判断淋巴结转移,并与术后病理结果进行对比。结果:78例患者中22例出现淋巴结转移。1淋巴结在长径、短长径比值、形态、边缘、强化表现几方面,各组之间差异均有统计学意义(P<0.05),强化密度差值各组之间比较,差异无统计学意义(P=0.715)。有统计学意义的各组表现综合分析结果显示,≥3项CT表现的灵敏度为77.27%,特异度为82.14%。2依据盆腔淋巴结的引流途径将淋巴结分为三站,其中以第二站的转移率最高(分别为11.54%、24.36%、7.69%)。结论:当淋巴结长径≥10 mm、短长径比值≥0.7、形态呈圆形或近似圆形及不规则形、边缘模糊或与周围组织有粘连、不均匀性强化或环形强化时,对淋巴结转移诊断价值较高。≥3项以上特征,淋巴结的转移可能性较大。早期宫颈癌淋巴结转移的分布有一定规律。

Objective： To explore the value of CT evaluation of lymph node metastasis in early-stage cervical carcinoma. Methods： Seventy-eight patients with cervical carcinoma detected by CT were enrolled in this study. The potential lymph node metastasis were evaluated by detecting factors, including the size, morphology, enhancement pattern and distribution. The results were compared with postoperative pathological finding. Results： There were 22 patients with lymph node metastasis in 78 patients. （1）There were significant differences among long-to-short diameter ratio, morphology, margin, enhaneement pattern （P〈0.05）. There was no significant difference between extant of enhaneement（P=0.715）. Among tile statistic results, the sensitiv- ity and specificity of them that were using above or equal to the three CT factors was 77.27%, 82.14% respectively. （2）Ac- cording to the pelvic lymph nodes draining path, the lymph nodes were divided into three stages, stage two was the highest （The rate of lymph node metastasis were 11.54%, 24.36%, 7.69% respectively）. Conclusion： Lymph node metastasis could be significantly diagnosed by long diameter with equal to or more than 10 mm, short-to-long ratio diameter with equal to or more than 0.7, circular or substantially circular or irregular shape, blurred edges or surrounding tissue adhesion, heterogeneous en- hancement or ring enhancement. Lymph node metastasis may character as one lymph node with three features or more. Distri- bution of lymph nodes may partly be valuable for diagnosing lymph node metastasis.