多模态磁共振成像在评估IB期宫颈癌大小及分期中的应用价值  

The usefulness of multimodal MRI in assessing tumor size and staging inpatients with FIGO stage IB cervical cancer

作　　者：宋凯林 边芳[1] 刘玉玲[2] 翟冬枝[1] SONG Kailin;BIAN Fang;LIU Yuling;ZHAI Dongzhi(Department of MRI,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院磁共振室,河南郑州450000 [2]郑州大学第二附属医院妇产科,河南郑州450000

出　　处：《暨南大学学报（自然科学与医学版）》2021年第2期203-209,共7页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：河南省科技计划基金项目(172102310031)。

摘　　要：目的:评价多模态磁共振成像(MRI),包括对比增强T1WI、平扫T2WI、扩散加权成像(DWI)、表观扩散系数(ADC)序列,在IB期宫颈癌病灶大小测量和分期中的应用价值.方法:回顾性分析76例经术后病理确诊为IB期宫颈癌患者的病例资料,所有患者术前行常规平扫、对比增强MRI和DWI检查,分别在各个序列图像上测量病灶的左右径、前后径及上下径,将测量值与手术病理结果值进行比较;根据序列图像对肿瘤进行分期,以手术病理结果作为分期的金标准,采用χ2检验比较4种序列及多模态MRI序列对宫颈癌分期的准确率.结果:对比增强T1WI及T2WI测得的病灶尺寸(对比病理结果)分别为左右径[(2.712±1.208)cm及(2.745±1.242)cmvs.(2.582±1.284)cm]、前后径[(2.201±0.975)cm及(2.288±1.106)cmvs.(2.132±1.165)cm]和上下径[(2.386±1.176)cm及(2.363±1.180)cmvs.(2.186±1.371)cm],MRI测量值与对应的病理测量值间均无统计学差异(P>0.05);多模态MRI肿瘤分期准确率最高(96.1%),与其他序列间具有统计学差异(P<0.001).结论:多模态MRI可以相对精确地评估宫颈癌IB期病灶的大小,并可明显提高肿瘤分期的准确率.Objective:To evaluate the function of magnetic resonance imaging(MRI)by comparing the accuracy of cancer lesion size measurement and the value of staging incontrast-enhanced T1WI,T2WI,diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)on cervical cancer patients diagnosed as IB stage.Methods:Data of 76 patients with stage IB cervical cancer confirmed by postoperative pathology were retrospectively analyzed.All patients underwent routine plain scan,contrast-enhanced MRI and DWI before surgery.The left and right diameters,anterior and posterior diameters,and upper and lower diameters of the lesions were measured on each image,and the measured values were compared with the surgical pathological results by t-test.Based on different sequence of images for staging,with the surgical pathology results as the gold-standard,the Chi-square method was conducted to compare the accuracy of four sequences for cervical cancer staging.Results:The left and right diameters,anterior and posterior diameters and upper and lower diameters of the lesions measured by ADC and DWI were all greater than the pathological measurements.T1WI enhanced staging had the highest accuracy.The differences between other sequences were statistically significant.Conclusion:Multimodal MRI can relatively accurately assess the size of stage IB lesions of cervical cancer,and contrast-enhanced T1WI is the most accurate sequences in staging.

关 键 词：磁共振成像(MRI) 宫颈癌 T分期 扩散加权成像 表观弥散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学]