磁共振弥散加权成像与增强CT在宫颈癌分期和诊断中的价值

Value of Diffusion-weighted Imaging and Enhanced CT in Staging and Diagnosis of Patients with Cervical Carcinoma

目的比较磁共振弥散加权成像(DWI)与增强CT在宫颈癌分期和诊断中的价值。方法选择宫颈癌患者85例,围术期均进行病理学检验以及DWI和CT检查。比较DWI和CT用于宫颈癌诊断分期结果与病理学分期结果的一致性,比较2种影像学检查方法显示肿瘤征象结果的不同。结果 DWI检出Ⅰb期、Ⅱa期、Ⅱb期以及Ⅲa期的检出率显著高于CT(P<0.05),但是2种检查方法对Ⅲb期、Ⅳ期的检出率差异不显著(P>0.05);DWI用于显示宫颈癌阴道浸润、子宫体浸润以及盆腔淋巴结转移的敏感性、特异性、阳性预测值及阴性预测值均高于CT。结论 DWI诊断分期的准确性以及判断肿瘤旁浸润程度和淋巴结转移情况敏感性、特异性高于增强CT,值得临床推广应用。

Objective To compare the value of diffusion-weighted imaging （DWI） and enhanced CT in staging and diagnosis of patients with cervical carcinoma. Methods 85 patients with cervical carcinoma were selected for pathological,DWI and CT examination in the perioperative period. The consistency between pathological results and DWI or CT results were com- pared and analyzed, and the characteristics of cervical carcinoma with DWI and CT were compared. Results The detection rate of Ⅰ b, Ⅱ a, Ⅱ b and Ⅲa with DWI were higher significantly than those CT （ P 〈 0.05 ） , but the difference of 2 imaging methods for detection Ⅲ b, Ⅳ had no significant difference （P 〉 0.05 ） ;The sensitivity, specificity, positive predictive value and negative predictive value of DWI for showing vaginal and uterus infiltration, and pelvic lymph node metastasis was respectively higher than those CT. Conclusion The accuracy of DWI staging and the sensitivity and specificity of tumor invasion,lymph node metastasis are higher than those of CT ,it is worthy of clinical application.