MRI对早期宫颈癌的诊断及分期评价

Diagnosis and staging evaluation of staging on early cervical cancer by MRI

目的评价MRI在宫颈癌诊断及分期中的价值。方法选择256例经病理确诊为宫颈癌的女性患者,年龄28~70岁,中位年龄46岁。术前行MRI检查,参照国际妇产科联盟(FIGO)标准进行MRI分期,将MRI分期和临床分期分别与手术病理所见对比,计算MRI诊断宫颈癌分期的准确度及判断宫旁浸润、阴道侵犯、淋巴结转移的灵敏度和特异度。结果Ⅰa期宫颈癌患者MRI检查有阳性发现者仅为50%,而Ⅰb期以上宫颈癌患者MRI检查均有阳性发现。MRI分期总准确度86.33%,临床分期总准确度84.38%。两者比较,差异无统计学意义(P>0.05)。MRI检查判断宫旁浸润、阴道侵犯、淋巴结转移的灵敏度和特异度分别为66.67%和80.00%、89.32%和91.89%、84.00%和90.32%。结论 MRI在宫颈癌的诊断和分期中有着重要价值,可以作为宫颈癌患者治疗前评估病变范围的常规检查。

Objective To investigate the value of magnetic resonance imaging（MRI） in the diagnosis and staging of cervical cancer. Methods A total of 256 female patients with pathological confirmed cervical cancer were enrolled, which aged 28 - 70 years old with median age of 46 years old. MRI was performed before surgery and MRI staging was in consistent with International Federation of Gynecology and Obstetrics（FIGO） standard. The results of all patients were compared with histopathologic findings after surgery, and calculated sensitivity and specificity of MRI in distinguishing parametrical invasion, vaginal invasion and lymph node metastasis. Results Only 50 % Ⅰ a patients showed positive MRI manifestations, but all the Ⅰ b patients showed positive MRI manifestations. In determining clinical stage of cervical cancer, the total accuracy rate of MRI- staging was 86.33 %, and total accuracy rate of clinical-staging was 84.38 %, and there was no significant difference（P 〉 0.05）. The sensitivity and the specificity of MRI in distinguishing parametrical invasion, vaginal invasion and lymph node metastasis were 66.67 % and 80.00 %, 89.32 % and 91.89 %, 84.00 % and 90.32 %. Conclusion It is demonstrated that MRI plays an important role in diagnosis and staging of cervical cancer, which could become a common method for preoperative evaluation of lesion scope in cervical cancer.