MRI诊断宫颈鳞癌58例与临床病理比较分析  

Comparative analysis of MRI diagnosis for cervical squamous cell carcinoma and clinical pathology:a report of 58 cases

作　　者：封春华 刘军锋 王建[3] 

机构地区：[1]铜川市人民医院妇产科,陕西铜川727000 [2]铜川市人民医院控制感染科,陕西铜川727000 [3]第四军医大学西京医院妇产科,陕西西安710032

出　　处：《中国医学物理学杂志》2016年第6期605-608,共4页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(81172458)

摘　　要：目的：用MRI诊断宫颈鳞癌并与临床病理进行比较分析,为宫颈癌诊断和防治提供临床依据。方法：回顾性选择分析铜川市人民医院经确诊58例宫颈鳞癌患者的MRI特征和分期,并与FIGO临床分期与病理诊断结果进行比较。结果：在58例宫颈鳞癌患者中,MRI诊断分期符合病理组织学分期达到93.1%（54/58）。与周围宫颈组织相比,宫颈癌的T_1WI呈等信号,T_2WI信号强度高于正常宫颈组织。宫颈癌浸润宫旁组织时,癌肿周围出现有中断或消失正常低信号带,Gd2DTPA增强后癌组织有不同程度强化。手术切除34例,单纯放疗24例。在单纯放疗病例中,早期出现信号完全消失4例;信号范围明显缩小16例;局部T_2WI序列呈现低信号4例。放疗结束1～3月复查,肿瘤信号完全消失7例;14例肿瘤不同程度缩小且局部T2WI序列呈低信号,出现程度不同的无强化区;3例无变化。结论：MRI诊断宫颈癌是可行和准确的,并能对癌肿浸润的范围进行多方位观察,可为临床诊断和预后评估提供依据。Objective To provide clinical evidence for the diagnosis and treatment of cervical cancer by comparing the MRI diagnosis for cervical squamous cell carcinoma and the clinical pathology. Methods The MRI features and staging of 58 patients confirmed with cervical squamous cell carcinoma in Tongchuan People＇s Hospital were retrospectively analyzed, and compared with the clinical staging of federation international of gynecology and obstetrics （FIGO） and pathological diagnostic results. Results For the 58 patients with cervical squamous cell carcinoma, the rate of MRI diagnostic staging conformed to the pathological staging was 93.1% （54/58）. Compared with the surrounding cervical tissue, the T,WI of the cervical cancer showed equal signal, and the T_~WI signal intensity of cervical cancer was higher than that of normal cervical tissue. When the cervical carcinoma invading the parametrial tissue, the interrupted or disappeared normal low signals were appeared around the cancer, and Gd2DTPA enhanced cancer tissue had different degrees of enhancement. Thirty-four cases were surgically removed, while the other twenty-four cases were treated with radiotherapy alone. Among the cases treated with radiotherapy alone, 4 cases of tumor signals appeared early were completely disappeared; 16 cases of tumors had significant narrowing in the signal range; 4 cases of local T.,W1 sequence showed low signals. The patients were followed up in 1-3 months after radiotherapy. And the follow-up results showed that 7 cases of tumor signal appeared completely disappeared; 14 cases of tumors had different degrees of narrowing, with low signals in the local T2WI sequence and no enhancement area of different degrees; 3 cases did not had any changes. Conclusion MRI diagnosis for cervical cancer is feasible and accurate, with multi-directional observation on the extent of tumor infiltration, which can provide the basis for clinical diagnosis and prognosis evaluation.

关 键 词：宫颈癌 FIGO分期 磁共振成像 病理诊断 

分 类 号：R816.91[医药卫生—放射医学]