MRI平扫及动态增强对宫颈癌分期的评估价值  

Evaluation on the conventional and dynamic contrast-enhanced MRI in staging of cervical carcinoma

作　　者：李石坚[1] 张金平[1] 胡春秀[2] 张冉[1] 汤永祥[1] LI Shijian;ZHANG Jinping;HU Chunxiu;ZHANG Ran;TANG Yongxiang(Department of Radiology,Tongling People′s Hospital,Tongling 244000,China)

机构地区：[1]铜陵市人民医院影像科,安徽铜陵244000 [2]铜陵市人民医院妇产科,安徽铜陵244000

出　　处：《皖南医学院学报》2017年第6期598-601,共4页Journal of Wannan Medical College

摘　　要：目的:探讨MRI平扫及动态增强MRI对宫颈癌分期的评估价值。方法:回顾性分析42例宫颈癌患者MRI平扫及动态增强影像学特征。以病理分期为标准,对肿瘤治疗前MRI分期与临床妇科体检分期的准确性进行比较。在MRI图像上测得肿块容积,并分析其与病理分期级别高低之间的差别。结果:宫颈癌MRI平扫显示为宫颈区异常信号,动态增强早期及延迟期易与周围正常组织区分。42例患者中MRI分期为原位癌5例,ⅠA期8例,ⅠB期9例,ⅡA期17例,ⅡB期3例;临床体检分期为原位癌14例,ⅠA期7例,ⅠB期6例,ⅡA期12例,ⅡB期3例。以病理分期为标准,MRI分期准确率为76.19%(32/42),临床妇科体检分期的准确率为30.95%(13/42),两者差异有统计学意义(χ~2=17.28,P<0.01)。在MRI图像上测得病灶肿块平均容积为8.49 cm^3。其中ⅠA期肿块容积平均为1.24 cm^3(n=9),ⅠB期为4.33 cm^3(n=11),ⅡA期为12.28cm^3(n=11),ⅡB期为20.04 cm^3(n=6),肿块大小在病理分期级别高低方面差异有统计学意义(χ~2=23.57,P<0.01)。结论:MRI平扫及动态增强对病灶范围清晰显示有帮助,可提高宫颈癌治疗前分期的准确率。测量肿块容积大小对肿瘤术前分期评估具有一定的价值。Objective:To evaluate the value of MRI imaging in preoperative staging of cervical carcinoma.Methods:MRI imaging was retrospectively reviewed regarding the properties by plain scans and contrast enhanced scans in42cases of cervical carcinoma.Accuracies for the tumor staging were compared between preoperative findings and conclusions from clinical gynecological examination on the pathological staging basis.The tumor masses were measured in MRI images,and compared with the pathological staging of tumors.Results:Plain MRI scans indicated abnormal signal at the cervical lesions,and dynamic contrast enhanced(DCE)magnetic resonance imaging revealed distinction between lesions and the surrounding normal tissue in the early arterial and delayed phase imaging.By MRI staging of the tumor in the42patients,5were cervical carcinoma in situ,8in stageⅠA,9ⅠB,17ⅡA and3ⅡB.Clinical examination concluded cervical carcinoma in situ in14patients,stage ofⅠA in7,ⅠB in6,ⅡA in12andⅡB in3.Based on the pathological staging,the accuracy by MRI staging of cervical carcinoma and preliminary clinic staging was76.19%(32/42)compared to30.95%(13/42).The difference was significant(χ2=17.28,P<0.01).The mean mass volume measured in MRI was8.49cm3,and1.24cm3(n=9)for stageⅠA,4.33cm3(n=11)forⅠB,12.28cm3(n=11)forⅡA and20.04cm3(n=6)forⅡB.The difference was significant between mass volumes measured by MRI and pathological staging of the tumors(χ2=23.57,P<0.01).Conclusion:Conventional and dynamic contrast enhanced MRI may be conducive to defining of the cervical lesions and improving the accuracies of preoperative staging of cervical carcinoma.Measurement of the tumor mass by MRI can be valuable for the tumor staging before surgery.

关 键 词：磁共振成像 动态增强 宫颈癌 肿瘤分期 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]