摘要
目的:探讨磁共振成像技术(MRI)对宫颈癌临床分期的价值。方法:选择31例病理确诊为宫颈癌的中晚期患者在治疗前进行MRI检查,对其MRI成像特点进行分析记录,参照FIGO制订的标准,将临床妇检形成的分期和MRI盲法判定形成的分期分别与手术病理所见进行对比。结果:MRI对宫旁浸润的判断符合率为87%,敏感度为86%,特异度为88%,阳性预测值为86%,阴性预测值为88%,总的分期准确率为84%;对淋巴结转移预测的符合率为84%,敏感度为75%,特异度为87%,而临床妇检对宫旁浸润的判断符合率为81%,敏感度为79%,特异度为82%,阳性预测值为79%,阴性预测值为82%,总的分期准确率为71%。结论:①MRI对中晚期宫颈癌分期较临床妇检分期有较高的准确率,对判断宫旁浸润有着较高的符合率、敏感度和特异度。②在预测淋巴结转移方面,MRI有较高的符合率、敏感度和特异度,弥补了临床妇检的不足。③引入磁共振成像技术使宫颈癌分期有了更加可靠的客观依据,避免发生临床分期上过低或过高的判断,有利于选择、制定合理的治疗计划。
Objective： To evaluate the value of MRI in clinical stage of pretherapy cervical cancer. Methods：Thirty-one patients confirmed with cervical cancer whose tumor stage ranging from Ⅱ A to ⅣA undertook MRI and clinical physical examination 3-7 days prior to surgery. The imaging character were analyzed and recorded,according to FIGO standard, worked out and compared the difference between two methods. Results： MR had an accuracy of 84% in determining clinical stage of the disease,in distinguishing parametrical extension, the coincidence, sensitivity and specificity were 87 %, 86 %, and 88 % respectively, its positive and negative predictive value were 86 % and 88 %. In determining pelvic lymph node metastasis, The coincidence, sensitivity and specificity were 84% ,75% ,and 87% respectively. While clinical examination only had an accuracy of 71% in determining clinical stage of cervical cancer, the coincidence, sensitivity and specificity in differentiating parametrical extension were 81%, 79% and 82%, and its positive and negative predictive value were 79% and 82%. Conclusion： ① Compared MRI with clinical physical examination,the former is more accurate in determining stage of the disease and has a higher coincidence, sensitivity and specificity in differentiating parametrical extension. ②In determining pelvic lymph node metastasis,MR has a high coincidence,sensitivity and specificity which make up for the drawback of clinical physical examination. ③we have a reliable roof which help us avoid high or low evaluation in determining clinical stage of the cervical cancer by MRI. MRI is beneficial for us to select proper treatment for patients with cervical cancer.
出处
《实用临床医学（江西）》
CAS
2007年第10期108-111,共4页
Practical Clinical Medicine
基金
江西省卫生厅基金资助项目(050088)
关键词
磁共振成像
宫颈癌
肿瘤分期
magnetic resonance imaging
cervical carcinoma
tumor stage
