MRI、经阴道彩色多普勒超声联合检测宫颈癌的诊断效能研究

The Diagnostic Efficiency of MRI Combined with Transvaginal Color Doppler Ultrasound for Cervical Cancer

目的探究磁共振成像(MRI)联合经阴道彩色多普勒超声在宫颈癌中的诊断效能。方法选择2017年7月至2019年12月我院收治的78例宫颈癌患者作为研究对象,所有患者均行MRI及经阴道彩色多普勒超声检查,比较两种检查方式单独或联合诊断的效能。结果 78例患者经MRI检查均可见宫颈部位实性肿物,其中T_(1)WI主要表现为略低信号,T_(2)WI表现为高信号,增强扫描可见病灶强化程度低于宫颈肌层;宫颈癌在经阴道超声声像图中呈现为宫颈内混杂低回声肿物,宫颈前后径明显增大,宫颈管内膜线不规则或中断,多普勒血流呈现低阻力血流信号。MRI联合经阴道超声对深肌层浸润、阴道浸润、宫旁受累诊断符合率显著高于经阴道超声检查(P<0.05)。MRI联合经阴道超声评估宫颈癌Ⅰ期、Ⅱa期、Ⅱb期、Ⅲa期、Ⅲb期、Ⅳa期、Ⅳb期的符合率分别为93.33%、95.00%、100.00%、100.00%、100.00%、100.00%、100.00%,两者联合对Ⅰ期、Ⅱa期、Ⅲa期诊断符合度显著高于单纯阴道超声检查。结论 MRI联合经阴道彩色多普勒超声可为宫颈癌的诊断及病情评估提供更全面的资料,提高其诊断价值。

Objective To explore the diagnostic efficiency of magnetic resonance imaging(MRI)combined with transvaginal color Doppler ultrasound for cervical cancer.Methods Seventy-eight patients with cervical cancer admitted to the hospital between July 2017 and December 2019 were selected as the study subjects.All of them completed MRI and transvaginal color Doppler ultrasound.The efficiencies of the two methods of diagnosis alone or in combination were compared.Results MRI showed cervical solid tumors in all subjects.Besides,T_(1)WI mainly showed slightly low signal,T_(2)WI showed high signal,and enhanced scan showed lower enhancement of lesions than the cervical myometrium.The transvaginal ultrasonic images of cervical cancer showed mixed hypoechoic cervical masses,significantly increased anterior and posterior cervical diameter and irregular or interrupted cervical intima line.Doppler blood flow showed low-resistance blood flow signal.The coincidence rates of MRI combined with transvaginal ultrasound for the diagnosis of deep muscle invasion,vaginal invasion and parauterine involvement were significantly higher than those of transvaginal ultrasound alone(P<0.05).The coincidence rates of MRI combined with transvaginal ultrasound for evaluating cervical cancer at stageⅠ,stageⅡa,stageⅡb,stageⅢa,stageⅢb,stageⅣa,and stageⅣb were 93.33%,95.00%,100.00%,100.00%,100.00%,100.00%,and 100.00%,respectively.The coincidence rates of combined diagnosis of stageⅠ,Ⅱa,andⅢa were significantly higher than those of transvaginal ultrasound alone.Conclusion MRI combined with transvaginal color Doppler ultrasound can provide more comprehensive information for the diagnosis and evaluation of cervical cancer and improve the diagnostic value.