超声与MRI在宫颈癌分期中的应用研究

Application of Ultrasound and MRI in Staging of Cervical Cancer

目的探讨超声与MRI在宫颈癌分期中应用价值。方法回顾性分析医院61例经手术病理确诊为宫颈癌患者的术前阴道超声和MRI影像学资料,分析影像学表现,对比两种影像学诊断方式诊断宫颈癌及术前分期的准确性。结果 61例宫颈癌均经临床病理检查确诊,术前超声诊断宫颈癌及临床分期的准确率分别为60.66%、50.82%明显低于MRI的93.44%、85.25%(P<0.05)。37例超声表现异常,宫体不规则增大,子宫颈形态异常,回声不均匀改变;肿块呈实质性低回声,血流信号较正常组织丰富,宫颈黏膜线弯曲、中断或消失。9例淋巴结肿大,11例侵犯阴道,7例侵犯宫体,1例侵犯膀胱。57例MRI图像异常,T1WI等信号或低信号,T2WI以高信号为主,STIR序列上T2WI高信号,且高于平扫T2WI,增强扫描后有不同程度的强化。14例淋巴结肿大,15例侵犯阴道,10例侵犯宫体,2例侵犯膀胱,1例侵犯直肠。结论 MRI诊断宫颈癌及其分期的准确率高于超声,可为临床确定治疗方案提供客观资料。

Objective To explore the application value of ultrasound and MtkI in staging of cervical cancer..Methods The preoperative transvaginal ultrasound and MRI data of 61 patients with cervical cancer confirmed by surgery and pathology were analyzed retrospectively. The imaging findings were analyzed, and the accuracy rates in the diagnosis of cervical cancer and preoperative staging were compared between the two imaging diagnostic methods. Resldts 61 cases of cervical cancer were diagnosed by clinical and pathological examination. The accuracy rates of preoperative ultrasound in the diagnosis of cervical cancer and clinical stage （60.66%, 50.82%） were significantly lower than those of MtkI （93.44%, 85.25%） （P〈0.05）. Ultrasound of 37 cases showed abnormalities, irregular enlargement of uterine body, abnormal shape of uterine neck and inhomogeneous changes of echo. The tumors presented substantial low echo, and blood flow signals were richer than those in normal tissues. The cervical mucosa line was bent and interrupt or disappeared. There were 9 cases of lymph node enlargement, 11 cases of invasion of the vagina, 7 cases of invasion of the uterine and 1 cases of invasion of the bladder. MIM images of 57 cases were abnormal, showing equal signal or low signal on T1WI and high signal on T2WI, T2WI high signal on STIR sequence, higher than that of plain scan T2WI. After enhanced scan, there were different degrees of enhancement. There were 14 cases with lymph node enlargement, 15 cases with invasion of the vagina, 10 cases with invasion of the uterine, 2 cases with invasion of the bladder and 1 case with invasion of the rectum. Conclusion The accuracy of MRI in the diagnosis of cervical cancer and its staging is higher than that of ultrasound, which can provide objective information for clinical diagnosis and treatment.