MRI与经阴道彩超在早期宫颈癌术前评估中对照研究

Comparative Study of Magnetic Resonance Imaging and Transvaginal Ultrasonography on Early-stage Cervical Cancer Preoperative Assessment

目的比较MRI和经阴道彩色多普勒超声(TVUS)在早期宫颈癌术前评估中的应用价值。方法回顾性分析35例经手术病理证实的早期宫颈癌患者(临床分期为Ⅰb和Ⅱa期)的MRI及TVUS资料,统计分析单独应用MRI、TVUS及两者联合应用在早期宫颈癌术前评估的准确率。结果肿瘤直径、宫颈间质浸润、宫旁受累3项指标准确率两者差异无统计学意义(P>0.05),在阴道受侵准确率方面,MRI明显优于TVUS,两者差异具有统计学意义(P<0.05);淋巴结受累方面,准确率差异无统计学意义(P>0.05),TVUS灵敏度明显高于MRI,特异度低于MRI。在5项指标中,联合应用准确率明显优于单一检查,差异具有统计学意义(P<0.05)。结论 MRI和TVUS在早期宫颈癌诊断中各有优势,联合应用显著提高术前评估的准确率。

Objective To compare the preoperative assessment value of Magnetic resonance imaging（ MRI） and transvaginal ultrasonography（ TVUS） for early-stage cervical cancer. Methods The thirty-five patients of early-stage cervical cancer with MRI and transvaginal ultrasonography（ TVUS） imaging data in Kailuan general Hospital were retrospectively analyzed. The clinical stage of cases wereⅠb andⅡa and all patients underwent magnetic resonance imaging（ MRI） and transvaginal ultrasonography（ TVUS） examination preoperatively. We statististically analyzed the the accuracy rate of different methods and combined application. Results There were no significant differences between MRI and TVUS for tumor diameter,cervical stromal invasion and parametrial invasion. There was statistical difference（ P〈 0. 05） in the accuracy rate of vaginal invasion. In lymph node metastases,there was not statistical difference（ P〈 0. 05） for the accuracy rate. The Sensitivity of TVUS is higher than that of MRI,but the specificity is lower. There was statistical difference（ P〈 0. 05） in the accuracy rate between MRI combined with TVUS with a single-method in all projects. Conclusion There are respective advantages of MRI and TVUS. MRI combined with TVUS has key value and it can help to completely assess the extent of early stage cervical cancer.