MSCT和MRI对浸润性宫颈癌术前分期的价值对比  

Comparison of multi-slice spiral CT and MRI in the diagnosis of pre-surgical staging of invasive cervical cancer

作　　者：邱书珺[1] 陆晓兰[1] 蒋小平[1] 王家强[1] 顾倩[1] 

机构地区：[1]武警上海总队医院肿瘤放射诊疗中心,上海201103

出　　处：《放射学实践》2012年第1期77-80,共4页Radiologic Practice

摘　　要：目的:对比浸润性宫颈癌在MSCT和MRI上表现差异及术前分期价值。方法:搜集有手术病理结果证实的宫颈癌82例,术前行CT检查74例,行MRI检查63例,以术后病理分期为标准,计算并比较CT、MRI对不同期宫颈癌的诊断符合率;对比分析两组图像上肿瘤大小、阴道或穹窿侵犯、宫体侵犯以及宫旁侵犯,分别计算并比较诊断符合率、敏感度及特异度。结果:对≤ⅠB1期宫颈癌,CT和MRI诊断符合率分别为47.56%、70.73%,ⅠB2～ⅡA期分别为80.49%、87.80%,≥ⅡB期分别为91.46%、82.93%。在显示肿瘤方面,MRI对≤4cm癌肿、阴道或穹窿侵犯方面的显示优于CT;CT对宫体侵犯诊断灵敏度高,对盆腔转移淋巴结的诊断优于MRI。结论:对≤ⅠB1和ⅠB2～ⅡA的早中期浸润性宫颈癌术前行MRI检查更有价值;而对于≥ⅡB的晚期浸润性宫颈癌行MSCT检查则更具有价值。Objective：To retrospectively evaluate the significance of MRI and multi-slice Spiral CT（MSCT） for pretreatment staging of invasive cervical cancer.Methods：82 patients with biopsy-proven cervical cancer were enrolled in this study.74 patients underwent CT and 63 underwent MRI before surgery.Using surgicopathologic findings as the reference standard,to compare the accuracy of CT and MRI in various stages of cervical cancer,Tumor size,infiltration of vagina or fornix,corpus and parametrium involvement found in these 2 groups were compared and analysed,and the sensitivity,specificity and accuracy were calculated.Results：For stage ≤ⅠB1,the diagnostic accuracy was 47.56% for CT and 70.73% for MRI;for stage ⅠB2~ⅡA,the accuracy was 80.49% and 87.80% respectively;for advanced stage（≥ⅡB）,it was 91.46% and 82.93% respectively.MRI was superior to CT for delineating cervical carcinoma with the size smaller than 4.0cm and infiltration of vagina or fornix.CT is superior to MRI for the diagnosis of pelvic lymph node metastasis,and the sensitivity of CT in estimating corpus involvement was higher than that of MRI.Conclusions：MRI is useful in the evaluation of stage ≤ⅠB1 and ⅠB2~ⅡA invasive cervical cancer,and MSCT is useful for advanced cancer（stage≥ⅡB）.

关 键 词：宫颈肿瘤 磁共振成像 体层摄影术 X线计算机 病理学 

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