宫颈癌淋巴结转移的影像学诊断

Imaging diagnosis of lymph node metastasis in cervical cancer

宫颈癌是我国最高发的女性生殖道恶性肿瘤之一。淋巴结转移是宫颈癌术后复发的高危因素,可降低早期宫颈癌患者的5年生存率。2018年,国际妇产科联盟(FIGO)正式将淋巴结转移纳入宫颈癌的临床分期标准中,并明确影像学检查在评估宫颈癌原发病灶直径、宫旁侵犯及淋巴结转移中的作用。既往对宫颈癌淋巴结转移的影像学评估,主要是对淋巴结进行形态学评价,可能影响诊断的准确性。目前,功能性影像成像技术,如弥散加权成像(DWI)等越来越多应用于宫颈癌淋巴结转移的评估。笔者拟就宫颈癌淋巴结转移影像学诊断的现状及最新研究进展进行阐述,并着重讨论最新的功能成像技术在诊断宫颈癌淋巴结转移方面的临床应用。

Cervical cancer is one of the most common malignancies in women worldwide.Lymph node metastasis is a high risk factor for postoperative recurrence of cervical cancer,and it can reduce 5-year survival rate of patients with early cervical cancer.In 2018,International Federation of Gynecology and Obstetrics(FIGO)formally included lymph node metastasis in clinical staging criteria for cervical cancer,and clarified the role of imaging examination in assessing diameter of the primary cervical cancer lesion,parauterine invasion,and lymph node metastasis.Traditionally,the imaging evaluation of lymph node in patients with cervical cancer mainly depends on its morphology,which may lead to misdiagnosis.Recently,functional imaging modalities,such as diffusion-weighted imaging(DWI)have been used in the evaluation of lymph node metastasis of cervical cancer.This article will expound latest research progresses of multimodalities of imaging in the diagnosis of lymph node metastasis in cervical cancer patients,with focus on the evolving functional imaging.