对比MRI与经阴道彩色多普勒超声用于早期宫颈癌术前评估的价值

Comparison of values of MRI and transvaginal color Doppler ultrasonography in the preoperative evaluation of early cervical cancer

目的对比MRI与经阴道彩色多普勒超声用于早期宫颈癌术前评估的价值。方法随机选取2015年5月至2017年5月邢台市第三医院诊治的早期宫颈癌患者70例作为研究对象,所有患者均接受TVUS与MRI检查,术后均送组织进行病理检查,对TVUS、MRI、TVUS+MRI与手术病理诊断对照进行统计分析。结果 TVUS+MRI诊断肿瘤直径≤2cm、间质浸润≤1/2、淋巴结转移、阴道受侵、宫旁浸润的灵敏度、特异度、准确率、阳性预测值、阴性预测值均显著高于TVUS、MRI,其差异均具有统计学意义(均P<0.05),而MRI诊断阴道受侵的灵敏度、特异度、准确率、阴性预测值均显著高于TVUS,其差异均具有统计学意义(均P<0.05),阳性预测值显著低于TVUS(P<0.05),但TVUS、MRI诊断肿瘤直径≤2cm、间质浸润≤1/2、淋巴结转移、宫旁浸润的灵敏度、特异度、准确率、阳性预测值、阴性预测值之间的差异均不显著,均无统计学意义(均P>0.05)。结论 MRI与经阴道彩色多普勒超声用于早期宫颈癌术前评估的价值相当,联合检查能够显著提升诊断的准确率,值得推广。

Objective To compare the values of MRI and transvaginal color Doppler ultrasonography in the preoperative evaluation of early cervical cancer.Methods 70 cases of patients with early cervical cancer in our hospital from May 2015 to May 2017 were selected,all patients received TVUS and MRI examinations,all the tissues were sent for pathological examination,the TVUS,MRI,TVUS+MRI and operation pathology diagnosis were statistically analyzed.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TVUS+MRI in the diagnosis of tumor diameter less than 2cm,stromal invasion,lymph node metastasis,1/2 vaginal invasion,parametrial infiltration were significantly higher than TVUS,MRI(all P<0.05),and the the sensitivity,specificity,accuracy rate and negative predictive value of MRI in the diagnosis of vaginal invasion were significantly higher than TVUS(all P<0.05),the positive predictive value was significantly lower than TVUS(P<0.05),but the differences of sensitivity,specificity,accuracy,positive predictive value and negative predictive value between TVUS and MRI in the diagnosis of tumor diameter less than 2cm,less than 1/2,interstitial infiltration of lymph node metastasis,parametrial infiltration were not significant(all P>0.05).Conclusions The value of MRI and transvaginal color Doppler ultrasound in the preoperative evaluation of early cervical cancer is equivalent,and the combined examination can significantly improve the accuracy of diagnosis,so is worthy of promotion.