MRI在老年宫颈癌患者术前诊断及病理分期中的价值研究  

Study on the value of MRI in preoperative diagnosis and pathological staging of elderly patients with cervical cancer

作　　者：陆静 李蔚洪 陈中港 张弦[2] 

机构地区：[1]浙江省温州市中心医院放射科,浙江温州325000 [2]温州医学院附属第二医院影像科,浙江温州325000

出　　处：《中国医药导报》2016年第35期177-180,共4页China Medical Herald

基　　金：浙江省医药卫生科技计划项目(2008A120)

摘　　要：目的探讨MRI在老年宫颈癌患者术前诊断及病理分期中的价值。方法回顾性分析温州市中心医院2013年8月～2016年8月收治并经宫颈活检证实为宫颈癌的90例老年患者的临床资料及影像学资料，依据肿瘤在MRI图像上的位置、大小、信号特点及浸润范围等情况进行分期，并与术后病理分期结果进行比较。结果本组90例宫颈癌患者除3例Ia期在MRI上未被检测出，其余87例均被检出，即术前检出率为96．7％（87／90），且肿瘤形状为类圆形（64例）或不规则形（23例），在T1WI呈等信号者71例，呈稍低信号者16例，全部肿瘤在T2WI呈稍高信号，增强扫描后均出现不同程度强化。60例手术患者的肿瘤平均大小为（1．95±1．12）cm，术后病理测量标本平均大小为（1．94±1．11）cm，差异无统计学意义（P〉0．05）。以术后病理分期结果为金标准，临床分期的准确率为61．7％（37／60），NRl分期的准确率为86．7％（52／60），差异有统计学意义（P〈0．05）。结论MRI对老年宫颈癌患者的术前诊断准确率较高，且MRI分期准确率明显高于临床分期，能够提供出客观准确的诊疗依据，应作为影像学检查的最佳方法进一步推广与应用。Objective To discuss the value of MR[ in preoperative diagnosis and pathological staging in elderly patients with cervical cancer. Methods The general clinical and imaging data of 90 cases elderly patients with liver cervical cancer confirmed by cervical biopsy in Wenzhou Central Hospital from August 2013 to August 2016 was retrospectively analyzed. According to the location, size, signal characteristics and the infiltrative range of the tumor on MRI images, the staging was taken and compared with the postoperative pathological staging results. Results Ninety cases of cervical cancer patients except for 3 cases phase I a had not been detected on MRI, the remaining 87 cases were detected by MRI, so the preoperative diagnosis accuracy rate was 96.7% （87/90）. The shape of the tumor was class round （64 cases） or irregular shape （23 cases）, 71 cases showed equal signal in T1WI, 16 cases showed slightly low signal, all tumors showed slightly high signal in T2WI. After enhanced scanning, the tumors were enhanced in different degree. The aver- age tumor size of 60 patients was （1.95±1.12） cm, the average size of postoperative pathological measurement was （1.94±1.11） cm, the difference was not statistically significant （P 〉 0.05）. The postoperative pathological staging was the gold standard, the accuracy of clinical stage was 61.7% （37/60）, but the accuracy of MRI in installment was 86.7% （52/ 60）, so the difference was statistically significant （P 〈 0.05）. Conclusion MRI in elderly patients with cervical cancer preoperative diagnosis accuracy rate is higher, and the accuracy of MRI staging is significantly higher than that in Clin- ical stage. MRI can provide accurate diagnosis and treatment for cervical cancer patients, which should be used as the best method of imaging examination to further promotion and application.

关 键 词：MRI 宫颈癌 术前诊断 病理分期 

分 类 号：R737.33[医药卫生—肿瘤]