宫颈癌的MRI表现与分期诊断价值  

MRI findings of uterine cervical cancer and value of MRI in preoperative staging

作　　者：李新春[1] 商健彪[1] 伍筱梅[1] 曾庆思[1] 孙翀鹏[1] 何建勋[1] 钟志伟[1] 陈振松[2] 

机构地区：[1]广州医学院第一附属医院放射科,广东广州510120 [2]韶关粤北人民医院放射科,广东韶关512025

出　　处：《南方医科大学学报》2007年第3期352-354,共3页Journal of Southern Medical University

摘　　要：目的探讨MRI在宫颈癌诊断与术前分期中的价值,为临床选择治疗方案提供客观依据。方法回顾性分析72例具有完整临床资料及MRI资料的宫颈癌患者,重点观察原发肿瘤的大小、位置、信号特点及盆腔侵犯,对50例手术患者比较MR分期、临床分期及手术病理分期。检查方法平扫为SET1WI和快速自旋回波(TSE)T2WI,T2WI/SPIR及增强扫描T1WI成像。结果除1例IA期宫颈癌外,71例宫颈癌全部被MRI显示,T1WI为稍低或等信号,T2WI为高信号,与宫颈基质、子宫内膜及宫旁脂肪有良好的对比,GD-DTPA增强后T1WI轻度均匀或不均匀强化,MR定位诊断准确率为100%,对宫颈癌分期诊断准确率为86%,临床分期诊断准确率为64%(χ2=6.453,P<0.05)。50例宫颈癌MRI测量的大小为1.94±1.15,手术病理标本测量为1.94±1.11,两者比较无明显统计学差异(P<0.05)。结论MR能准确显示宫颈癌瘤灶大小及侵犯范围,对于发现宫旁侵犯方面明显优于临床,可作为中晚期宫颈癌常规的检查方法,但MRI对IA期宫颈癌的诊断价值有限,必须结合临床资料与宫颈刮片综合判断。Objective To evaluate the value of magnetic resonance imaging （MRI） in diagnosis and preoperative staging of uterine cervical cancer. Methods MRI findings and staging in 72 patients with cervical carcinoma were retrospectively analyzed, and the size, location, signal intensity and invasion of the tumor were observed. MRI sequence included SE TIWI, （TSE）T2WI, T2WI/SPIR and contrast-enhanced TIWI. Results MRI identified uterus cervical cancer in all cases with the exception of only I case of IA stage. The tumor was represented by hypointensity and isointensity on TIWI, heterogeneous and homogeneous hypefintensity on T2WI, mildly heterogeneous enhancement after bolus intravenous GD-DTPA injection. MRI had an accuracy of 86% in localization of the tumor, but its accuracy in clinical staging was only 64% （X^2=6.453, P〈 0.05）. The tumor volunme measured by MRI was similar with that by pathological measurement （1.94v1.15 vs 1.94±1.11, P〉 0.05）. Conclusion MRI can accurately describe the size and invasion of uterine cervical cancer, especially useful in detecting parametrial invasion, but for diagnosis of IA uterine cervical cancer, MRI findings are not sufficient without considerations of clinical findings and cellular examination.

关 键 词：子宫颈癌 磁共振成像 分期 

分 类 号：R737.33[医药卫生—肿瘤]