多模态磁共振联合多普勒超声对宫颈癌的诊断价值

Diagnostic value of multimodal MRI combined with Doppler ultrasound for cervical cancer

目的探讨多模态磁共振联合多普勒超声对宫颈癌的诊断价值。方法选取2017年10月至2020年10月间西北妇女儿童医院和延安市人民医院收治的200例宫颈癌患者作为研究对象。采用随机数表法分为A组(66例)、B组(67例)和C组(67例),A组患者进行多模态磁共振检查,B组患者进行多普勒超声检查,C组患者进行多模态磁共振联合多普勒超声检查。均以术中病理活检作为金标准,对比三组患者的诊断确诊率与误诊、漏诊率、病理类型检出率、显示征象以及三组患者的诊断准确度、特异度与敏感度。结果 A组患者的宫颈癌检出率为87.9%,B组患者为71.6%,C组患者为95.5%,三组组间两两比较,差异均有统计学意义(均P <0.05),C组患者的误诊率和漏诊率低于A组和B组,组间对比,差异均有统计学意义(均P <0.05)。A组、B组和C组患者宫颈癌分期评价对比分析发现,三组患者Ⅱ期、Ⅲ期、Ⅳ期宫颈癌的检出率比较,差异无统计学意义(P> 0.05),三组患者I期宫颈癌的检出率比较,差异有统计学意义(P <0.05)。通过三组患者准确度、特异度和敏感度对比分析发现,C组患者准确度、敏感度高于A组,A组高于B组,差异均有统计学意义(均P <0.05),三组患者特异度比较,差异无统计学意义(P> 0.05)。结论多模态磁共振联合多普勒超声检查能够更准确地辨别宫颈癌,对宫颈癌的分期评价具有重要价值,而且相比于两种单一检查确诊率更高,值得临床应用推广。

Objective To explore the diagnostic value of multimodal magnetic resonance imaging( MRI) combined with Doppler ultrasound for cervical cancer. Methods Two hundred patients with cervical cancer were selected at Northwest Women and Children’s Hospital and Yan’an People’s Hospital from October 2017 to October 2020. Using the random number table method,the patients were divided into group A( 66 patients),group B( 67 patients) and group C( 67 patients). Multimodal MRI was performed on the patients in group A,Doppler ultrasound was performed on the patients in group B,and multimodal MRI combined with Doppler ultrasound were performed on the patients in group C. The diagnostic accuracy,specificity and sensitivity as well as diagnostic miss rate,diagnostic error rate,pathological types-related detection rate and signs displayed were compared among the three groups. Results The detection rate of cervical cancer was 87. 9%,71. 6% and 95. 5%,respectively in group A,group B and group C( P < 0. 05). The diagnostic miss rate and diagnostic error rate were lower in group C than in group A and group B( all P <0. 05). The detection rate of stage Ⅱ,stage III and stage IV cervical cancer was high among the three groups( P > 0. 05). However,there was significant difference in the detection rate of stage I cervical cancer among the three groups( P < 0. 05). By comparing the accuracy,specificity and sensitivity among the three groups,it was found that there was significant difference in the accuracy and sensitivity were higher in group C than in group A followed by group B( all P < 0. 05). There was no significant difference in the specificity among the three groups( P > 0. 05). Conclusion Multimodal MRI combined with Doppler ultrasound can detect cervical cancer more accurately,which has important value for assessing staging of cervical cancer with high diagnostic accuracy compared with each of the two single examination approach,which is worthy of clinical application and promotion.