3.0T磁共振及弥散加权成像对宫颈癌术前评估的临床价值研究

Clinical value of 3.0T magnetic resonance and diffusion weighted imaging in preoperative evaluation of cervical cancer

目的探讨3.0T磁共振弥散加权成像对宫颈癌分期的临床价值。方法选取2016年6月~2018年12月我院收治的71例排除不符合入组条件的宫颈癌患者作为研究对象。观察对比符合以宫颈癌国际妇产科联盟(FIGO)2009分期为金标准的临床术后病理结果与MR平扫及DWI检查中的宫颈癌分期等指标的一致性,观察磁共振成像在诊断宫颈癌的特异性、灵敏性及准确性。结果术前MR常规序列检查联合DWI扫描评估宫颈癌术前分期与术后病理结果比较:以手术及病理诊断分期为金标准,术前MR常规序列检查联合DWI功能成像诊断宫颈癌分期准确性为87.5%(63/71),与病理检查有很高的一致性(Kappa=0.89,P<0.05);术前MR常规序列检查联合DWI扫描评估宫颈癌术前分期与术后病理结果分析:对于Ⅰ期、Ⅱ期、Ⅲ期及Ⅳ期分期其各期准确性、特异性及灵敏性均在80%以上,其中Ⅳ期诊断三项指标达100.00%。结论3.0T磁共振弥散加权成像对于宫颈癌诊断、分期辅具有较高的临床价值,为临床治疗方案的选择提供可靠的参考依据,值得临床进行推广应用。

Objective To investigate the clinical value of 3.0T magnetic resonance diffusion weighted imaging in staging of cervical cancer.Methods 71 patients with cervical cancer admitted in our hospital from June 2016 to December 2018 were selected as subjects,excluding those who did not meet the enrollment criteria.The consistency of clinical postoperative pathological results which were in line with International Federation of Gynecology and Obstetrics of cervical cancer(FIGO)2009 staging as the gold standard with the indexes of cervical cancer staging in MR plain scan and DWI was observed and compared.The specificity,sensitivity and accuracy of magnetic resonance imaging in diagnosing cervical cancer were observed.Results The preoperative staging of cervical cancer evaluated by preoperative MR routine sequence examination combined with DWI scan was compared with postoperative pathological results.Choosing surgical and pathological diagnosis staging as the gold standard,the accuracy of preoperative MR routine sequence test combined with DWI functional imaging in diagnosing cervical staging was 87.5%(63/71),with high consistency with pathological examination(Kappa=0.89,P<0.05).Preoperative MR routine sequence examination combined with DWI scan to evaluate preoperative staging and postoperative pathological results of cervical cancer was analyzed.The accuracy,specificity and sensitivity of stageⅠ,stageⅡ,stageⅢand stageⅣwere all above 80%,of which the three indicators of phaseⅣdiagnosis reached 100.00%.Conclusion 3.0 T magnetic resonance diffusion-weighted imaging has a high clinical value for the diagnosis and staging of cervical cancer,and provides a reliable reference for the selection of clinical treatment options.It is worthy of clinical application.