MRI平扫及增强扫描在宫颈病变中应用研究

Application of MRI Plain Scan and Enhanced Scan in Cervical Lesions

目的研究MRI平扫及增强扫描在宫颈病变中应用价值。方法选取2013年6月至2015年3月我院收治的宫颈病变患者45例为研究对象,术前均行CT、MRI平扫及增强扫描,观察其MRI影像特点,并以手术病理分期为准,对比CT及MRI诊断宫颈癌各征象的准确度,分析MRI平扫及增强扫描诊断宫颈病变各分期的符合率。结果 MRI平扫及增强扫描显示子宫体积稍增大,子宫颈见不规则软组织肿块,呈等T1等短T2信号改变、压脂呈等信号,DWI呈高信号,边界欠清,宫体及阴道受侵犯,增强扫描强化程度低于正常子宫而呈稍低信号改变,盆腔、宫腔内见长T1长T2信号影;以病理结果为准,MRI增强扫描对宫颈癌分期Ⅰb1期及以下的诊断符合率84.6%明显高于平扫50.0%(P<0.05),Ⅰb-Ⅱa期、Ⅱb期及以上的诊断符合率差异无统计学意义(P>0.05),MRI增强扫描总分期诊断符合率84.4%高于平扫68.9%(P<0.05)。结论MRI平扫及增强扫描诊断宫颈癌分期的准确度高于CT,且增强扫描后准确度明显提高,值得在临床推广应用。

Objective To study the application value of MRI plain scan and enhanced scan in cervical lesions. MethodsForty-five patients with cervical lesions admitted in our hospital between June 2013 and March 2015 were selected as the study subjects. CT and MILI plain scan and enhanced scan were performed before operation, and the MRI findings were observed. With the surgical and pathological staging as the standard, the accuracy rates of CT and MRI in the diagnosis of signs of cervical cancer were compared, and the coincidence rates of MRI plain scan and enhanced scan in the diagnosis of different cervical cancer stages were analyzed. Results MRI plain scan and enhanced scan showed slightly increased volume of uterus, and there were irregular soft tissue masses in uterus, showing equal T1 and equal short T2 signal changes. Fat suppression showed equal signal, and DWI showed high signal. The boundaries were unclear, and the uterus and vagina were invaded. The degree of enhancement of enhanced scan was lower than that of normal uterus, showing slightly lower signal changes. Pelvic and uterine cavity showed long T1 and long T2 signal.With the pathological results as the standard, the coincidence rate of MRI in the diagnosis of cervical cancer I b1 stage or lower stage （84.6%） was significantly higher than that of plain scan （50.0%） （P〈0.05） while there was no significant difference in the coincidence rates in the diagnosis of I b-Ⅱa, I b stage and higher stage （P〉0.05）. The coincidence rate of MRI enhanced scan in the diagnosis of total stage （84.4%） was higher than that of plain scan （68.9%） （P〈0.05）. Conclusion The accuracy of MRI plain scan and enhanced scan in the diagnosis of cervical cancer stage is higher than that of CT, and the accuracy is significantly improved after enhanced scan.