经阴道彩色多普勒超声联合多模态MRI在宫颈癌诊断中的临床应用  

The clinical value of transvaginal color Doppler ultrasound combined with multimodal MRI in the diagnosis of cervical cancer

作　　者：徐萌[1] 王晓文 秦丽娜[3] XU Meng;WANG Xiaowen;QIN Lina(Department of Ultrasound,Ji’nan Maternal and Child Health Hospital,Ji'nan 250001,China;Department of Radiology,Jinan Maternal and Child Health Hospital,Ji'nan 250001,China;Department of Ultrasound,Ji'nan Fourth People's Hospital,Ji'nan 250001,China)

机构地区：[1]济南市妇幼保健院超声科,山东济南250001 [2]济南市妇幼保健院放射科,山东济南250001 [3]济南市第四人民医院超声科,山东济南250001

出　　处：《实用放射学杂志》2021年第10期1651-1654,1667,共5页Journal of Practical Radiology

摘　　要：目的研究经阴道彩色多普勒超声(TVCDS)联合多模态MRI影像表现与宫颈癌患者病理分期、病灶检出率及疗效评定的关系.方法回顾性分析经病理确诊的105例宫颈癌患者的TVCDS、多模态MRI影像学资料,以手术病理诊断结果为参照,比较2种影像学方法单用、联用时与病理分期、病灶检出率的关系以及在评价疗效中的应用价值.结果105例早期宫颈癌患者国际妇产科联盟(FIGO)分期法分为Ⅰb期25例,Ⅱa期46例,Ⅱb期34例,MRI、TVCDS联合检查诊断率明显高于单独检查(P<0.05).间质浸润≤1/2、肿瘤直径≤2cm、淋巴结转移、阴道受侵、宫旁浸润患者分别有75例、72例、80例、78例、43例,其中联合检查间质浸润≤1/2、肿瘤直径≤2cm、阴道受侵、宫旁浸润的检出率明显高于单独检查(P<0.05).治疗后患者表观扩散系数(ADC)值、收缩期的血流峰值速度(PSV)均明显增加,早期增强率(EER)、阻力指数(RI)明显降低(P<0.05).治疗有效患者67例,无效患者38例,其中有效组患者EER值、RI值显著低于无效组患者,而ADC、PSV值显著高于无效组患者(P<0.05).结论TVCDS联合多模态MRI检查可准确诊断病理分期和提高病灶检出率,可为疗效评定提供参考依据,有助于指导临床制订最佳治疗方案.Objective To evaluate the relationship between transvaginal color Doppler ultrasound(TVCDS)combined with multimodal MRI and the pathological stage,detection rate and therapeutic effect of cervical cancer.Methods The TVCDS and multimodal MRI data of 105 cases with cervical cancer confirmed by pathology were analyzed retrospectively.With reference to the results of surgical and pathological diagnosis,the relationship between the single and combined use of the two imaging methods and pathological stage,lesion detection rate and the application value for evaluating the curative effect were compared.Results 105 cases of early cervical cancer were divided into 25 cases of Ⅰb stage,46 cases of Ⅱa stage and 34 cases of Ⅱb stage by International Federation of Gynecology and Obstetrics(FIGO)staging.The diagnostic rate of MRI and TVCDS combined examination was significantly higher than that of single examination(P<0.05).There were 75 cases,72 cases,80 cases,78 cases and 43 cases of interstitial infiltration≤1/2,tumor diameter≤2 cm,lymph node metastasis,vagina invasion and parametrial invasion respectively.The detection rate of interstitial infiltration≤1/2,tumor diameter≤2 cm,vagina invasion and parametrial invasion by combined examination was significantly higher than that by single examination(P<0.05).After treatment,the apparent diffusion coefficient(ADC)and peak systolic velocity(PSV)were significantly increased,while early enhancement rate(EER)and resistance index(RI)were significantly decreased(P<0.05).There were 67 cases of effective patients and 38 cases of invalid patients,among which the EER and RI values in the effective group were significantly lower than those in the invalid group,while the ADC and PSV values were significantly higher than those in the invalid group(P<0.05).Conclusion TVCDS combined with multimodal MRI can accurately diagnose pathological stages and improve the detection rate of lesions,which provides reference for the evaluation of curative effect and guides to make the best trea

关 键 词：宫颈癌 经阴道彩色多普勒超声 磁共振成像 

分 类 号：R737.33[医药卫生—肿瘤] R445.1[医药卫生—临床医学]