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磁共振在宫颈癌诊断中的应用

Application of MRI in the diagnosis of cervical cancer

摘要目的:本研究旨在探讨磁共振对宫颈癌的诊断价值,包括术前分期、阴道受累及淋巴结转移。方法:选取2016年10月到2019年4月入住吉林大学第二医院妇产科的宫颈癌患者,共116例。所有患者术前均行磁共振检查。所有患者最终均行手术治疗。釆用SPSS19.0软件对所有患者磁共振结果进行分析。以术后病理学检查结果为诊断宫颈癌的金标准。采用χ 2检验,对磁共振术前分期、术前临床分期及术后病理分期计数资料率比较,釆用Mcnemar χ 2检验对术前磁共振对宫颈癌阴道受累及淋巴结转移诊断方面和术后病理结果计数率比较。 结果:(1)116例宫颈癌患者磁共振分期与术前临床分期的差异有统计学意义( P<0.05),而磁共振分期与术后病理学分期的差异无统计学意义( P>0.05)。以术后病理学分期结果为参照,术前临床分期准确度仅67.5%(78/116),而术前磁共振检查总体分期准确度为95%(110/116);(2)术前磁共振诊断与术后病理学结果在宫颈癌阴道受累及淋巴结转移方面比较均有较高的灵敏性及特异性,分别达到97.0%、96.2%,93.2%及97.8%。两者之间的差异无统计学意义( P>0.05)。 结论:磁共振检查联合国际妇产科联盟临床分期可以使宫颈癌分期更加准确,磁共振可以作为评估宫颈癌术前准确分期的重要工具,并以此来选择、制定合理的子宫颈癌治疗计划。

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abstractsObjective:Investigating the diagnostic value of MRI for cervical cancer, including preoperative staging, vagina involvement and lymph node metastasis is the aim of this pape.Methods:Select 116 patients with UCC of the second hospital of JiLin University from October 2016 to April 2019. All patients accept MRI examination. Ultimately, all patients accept surgical treatment. Use SPSS19.0 software to analyze MRI results of all the patients.Using the postoperative pathological results as the golden standard in the diagnosis of cervicalcancer diagnosis. The dates from the MRI preoperative staging, preoperative clinical staging and the postoperative pathologic staging were compared through chi-square test. And the dates of preoperative MRI in cervical cancer vagina involvement and lymph node metastasis diagnosis and postoperative pathological results were compared through Mcnemar chi-square test. The difference was statistically significant( P<0.05). Results:1, The differences between MRI staging and the postoperative pathologic staging have no statistical significance ( P>0.05), whilethe difference between MRI staging and preoperative clinical staging during was statistically significant ( P<0.05). Using the postoperative pathological staging as the examination standards, the accuracy of preoperative clinical staging is only 67.5%, and cervical cancer overall preoperative MRI staging accuracy was 95%; 2, Preoperative MRI diagnosis and postoperative pathologic results in cervical vaginal involvement and lymph node metastasis has highsensitivity and specificity, were 97.0%, 96.2%, 93.2%, 97.8%. Checked by Mcnemar chi-square test, the differences between themhave no statisticalsignificance ( P>0.05), namely the preoperative MRI diagnosis and postoperative pathological results have consistency in clinical. Conclusion:The combination of MRI and FIGO clinical stage can impro the accuracy of clinical staging of cervical cancer. MRI can be used as the important tool to assess cervical cancer preoperative staging, and to choose and formulate reasonable cervical cancer treatment plan.

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中华医学杂志

中华医学杂志

2020年100卷14期

1081-1083页

MEDLINEISTICPKUCSCDCA

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