宫颈癌（IB—IVA期）盆腔局部淋巴结转移的CT诊断  

CT Diagnosis of Pelvic Regional Lymph Node Metastasis in Cervical Cancer （FIGO Staging：IB--IVA）

作　　者：吕益忠[1] 姜海霞[1] 丁玉兰[1] 严建春[1] 胡东劲[1] 

机构地区：[1]江苏大学附属镇江市第四人民医院放射科,江苏镇江212000

出　　处：《实用放射学杂志》2009年第6期829-832,共4页Journal of Practical Radiology

摘　　要：目的探讨宫颈癌盆腔局部淋巴结转移的CT表现及诊断价值。方法52例有完整手术病理资料的宫颈癌（IB—IVA期）患者，以结节最短直径为10mm或边缘分叶毛刺为标准判断CT对盆腔局部区域存在淋巴结转移的诊断价值，再结合手术病理结果对CT显示的73枚淋巴结分转移组与非转移组，测量2组淋巴结最短径，判断边缘是否分叶或毛刺、强化是否均匀，比较2组结果差异。结果CT显示转移与非转移性淋巴结大小[（9．1±2．5）mmVS（7．2±3．8mm），P〈0．053、边缘是否分叶或毛刺（70．4％vs30．4％，P〈0．01）差异有统计学意义，转移性淋巴结多表现不均匀强化，但本组资料无统计学差异（59．3％vs40．2％，P〉0．05）。以淋巴结最短直径为10mm或边缘分叶毛刺判断盆腔局部区域存在淋巴结转移的敏感性为62％，特异性为94．5％，阳性预测值为60．5％，准确性为90．7％。结论CT对判断盆腔局部存在转移性淋巴结有较高价值。Objective To investigate the CT fingings of pelvic lymph node metastases from cervical cancer and its diagnostic value. Methods 52 cases of cervical cancer with integral pathological data were involved in this study. 73 lymph nodes in 52 cases showed by CT were divided into metastatic group （group A} and non--metastatic group（group B） based on pathologic findings,the short diameters of the lesions were measured, and the margins and contrast--enhancement of nodules were also evaluated on CT. Resuits CT showed the size of lymph nodes were （9. 1±2.5） mm and {7.2±3.8） mm（P〈0.05） and the lobulated or spiculated border or not were 70.4% and 30.4 % （P〈0.01） in group A and group B, respectively, there were significant difference between two groups. Heterogeneous enhancement was more commonly seen in metastatic lymph nodes than in nonmetastatic lymph node（59.3% vs 40.2%） ,but there was not statistically significant difference （P〉0.05）. The sensitivity , specificity , positive predictive value and accuracy of CT based on the criterion which the short diameter of nodes was 10 mm , lobulated or spiculated border were 62%, 94.5 % ,60.5% and 90.7%, respectively for assessing pelvic local lymph node metastasis. Conclusion CT have a high value in predicting pelvic regional lymph node metastasis from cervical cancer.

关 键 词：宫颈癌 体层摄影术 X线计算机 淋巴结 转移 

分 类 号：R737.33[医药卫生—肿瘤] R814.42[医药卫生—临床医学]