MRI常规平扫及增强序列对宫颈癌术前分期及淋巴结转移的评估  

Evaluation of preoperative staging and lymph node metastasis of cervical cancer using routine MRI plain and enhanced sequences

作　　者：刘辉[1] 张海金[1] 陈鉴[1] 刘俊 LIU Hui;ZHANG Haijin;CHEN Jian;LIU Jun(Department of Radiology,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China;Department of Pediatric Surgery,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China)

机构地区：[1]浙江省嘉兴市妇幼保健院放射科,浙江嘉兴314000 [2]浙江省嘉兴市妇幼保健院小儿外科,浙江嘉兴314000

出　　处：《医学影像学杂志》2024年第12期131-134,共4页Journal of Medical Imaging

基　　金：浙江省医药卫生科技计划项目(编号:2022RC271)。

摘　　要：目的探讨磁共振成像(MRI)常规平扫及增强序列对宫颈癌患者术前分期及淋巴结转移的评估价值。方法选取收治的86例宫颈癌患者临床资料,所有患者术前均完成MRI常规平扫及动态对比增强磁共振成像(DCE-MRI)检查,并于检查后1周内完成手术治疗。以术后病理结果为金标准,分析MRI常规平扫及增强序列对宫颈癌术前分期及淋巴结转移的评估价值。结果手术病理诊断结果,86例宫颈癌患者中ⅠB期28例、ⅡA期22例、ⅡB期15例、ⅢA期21例。MRI常规平扫、DCE-MRI检查诊断宫颈癌术前分期结果的总符合率分别为80.23%(69/86)、95.35%(82/86),DCE-MRI检查总符合率高于MRI常规平扫(χ^(2)=9.167,P=0.003)。经Kappa一致性检验,MRI常规平扫、DCE-MRI检查诊断宫颈癌术前分期结果与手术病理诊断结果的一致性Kappa值分别为0.745、0.939,DCE-MRI检查诊断宫颈癌术前分期与金标准的一致性更好。86例宫颈癌患者共清扫淋巴结502枚,其中盆腔转移性淋巴结133枚,非转移性淋巴结369枚。MRI常规平扫诊断宫颈癌盆腔淋巴结转移结果与手术病理诊断结果的一致性一般(Kappa=0.747,P<0.001),DCE-MRI检查诊断宫颈癌盆腔淋巴结转移结果与手术病理诊断结果的一致性较好(Kappa=0.846,P<0.001)。DCE-MRI检查诊断宫颈癌盆腔淋巴结转移的灵敏度、准确度均高于MRI常规平扫(P<0.05)。结论较MRI常规平扫,DCE-MRI对宫颈癌术前分期及淋巴结转移有更高的诊断效能。Objective To explore the evaluation value of routine plain and enhanced magnetic resonance imaging(MRI)sequences for preoperative staging and lymph node metastasis in cervical cancer patients.Method A retrospective analysis was conducted to collect clinical data of 86 cervical cancer patients.All patients were completed routine MRI plain scan and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)examination before surgery,and underwent surgical treatment within one week after completion of the examination.Postoperative pathological results were used as the gold standard to analyze the evaluation value of routine MRI plain and enhanced sequences for preoperative staging and lymph node metastasis of cervical cancer.Results According to the surgical pathological diagnosis,among 86 cervical cancer patients,there were 28 cases in stage 1B,22 cases in stage ⅡA,15 cases in stage ⅡB,and 21 cases in stage ⅢA.The total conformity rates of routine MRI plain scan and DCE-MRI examination in diagnosing preoperative staging of cervical cancer were 80.23%(69/86)and 95.35%(82/86),respectively.The total conformity rate of DCE-MRI examination was higher than that of routine MRI plain scan(χ^(2)=9.167,P=0.003).By Kappa consistency measurement,the consistency Kappa values of MRI routine plain scan and DCE-MRI examination in the diagnosis of preoperative staging of cervical cancer were 0.745 and 0.939,respectively.The consistency between DCE-MRI examination and gold standard in the diagnosis of preoperative staging of cervical cancer was better.A total of 502 lymph nodes were cleaned in 86 patients with cervical cancer,including 133 pelvic metastatic lymph nodes and 369 non metastatic lymph nodes.The consistency between the results of routine MRI plain scan diagnosis of cervical cancer pelvic lymph node metastasis and surgical pathological diagnosis was generally low(Kappa=0.747,P<0.001),while,the sensitivity and accuracy of CE-MRI examination in diagnosing pelvic lymph node metastasis of cervical cancer were higher

关 键 词：宫颈癌 分期 淋巴结转移 磁共振成像 诊断 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]