3.0T MRI功能成像对宫颈癌术前分期的临床价值

Clinical Value of 3.0T MRI Functional Imaging in Preoperative Staging of Cervical Cancer

目的探讨3.0T MRI功能成像对宫颈癌术前分期的临床诊断价值。方法选取2012年9月至2017年5月期间郑州大学附属医院/南阳市中心医院收治的108例宫颈癌患者为研究对象,均使用GE 3.0T磁共振扫描仪以快速自旋回波(FSE)序列行横轴位、矢状位扫描,以横轴位平面回波成像(ERPI)序列行弥散加权成像(DWI)扫描。根据影像学特点确定宫颈癌分期、分化程度,并与术后病理诊断结果对比。结果术前MRI分期和术后病理分期比较差异无统计学意义(χ~2=2.77,P>0.05),MRI对宫颈癌临床分期Ⅰb期、Ⅱa期、Ⅱb期、Ⅲa期、Ⅲb期、Ⅳa期及Ⅳb期鉴别诊断准确性依次为84.62%、87.50%、75.00%、80.00%、77.78%、86.67%、90.91%,敏感性依次为78.57%、82.35%、83.33%、75.00%、82.35%、81.25%、100.00%。术前MRI分化程度和术后病理分化程度诊断结果比较差异无统计学意义(χ~2=0.09,P>0.05),MRI对宫颈癌中低分化、高分化鉴别诊断准确性分别为90.67%、80.00%,敏感性分别为93.15%、80.00%。结论 3.0T MRI功能成像对于宫颈癌术前精确分期有较高的准确性及特异性,并可用于评价其分化程度,临床应用价值高。

Objective To evaluate the clinical value of 3.0T MRI functional imaging in preoperative staging of cervical cancer.Methods 108 patients with cervical cancer treated in the Affiliated Hospital of Zhengzhou University/Nanyang Central Hospital from September 2012 to May 2017were selected as the subjects.All patients underwent transverse axial and sagittal scanning performed with GE 3.0T magnetic resonance scanners by the fast spin echo(FSE)sequence.The transverse axial echo planar imaging(EPI)sequence was used for diffusion weighted imaging(DWI)scanning.The stage and differentiation degree of cervical cancer were determined according to the imaging findings,and the results were compared with the results of pathological diagnosis after operation.Results There was no significant difference in preoperative MRI staging and postoperative pathological staging(χ2=2.77,P>0.05).The accuracies of MRI in the diagnosis of clinical stage I b,stage II a,stage II b,stage III a,stage III b,stage IV a and stage IV bof cervical cancer were 84.62%87.50%,75.00%,80.00%,77.78%,86.67%and 90.91%,respectively while the sensitivities were 78.57%,82.35%,83.33%,75.00%,82.35%,81.25%and 100.00%.There was no statistically significant difference in differentiation degree diagnosed by preoperative MRI and postoperative pathology(χ2=0.09,P>0.05).The accuracies of MRI in the diagnosis of low to moderate differentiation and high differentiation of cervical cancer were 90.67%and 80.00%,respectively,and the sensitivities were 93.15%and 80.00%,respectively.Conclusion 3.0T MRI functional imaging is of high accuracy and specificity for accurate staging of cervical cancer,and it can be used to evaluate thedifferentiation degree.