摘要
目的探讨磁共振成像(MRI)在宫颈癌和子宫内膜癌分期中的应用价值并分析MRI误判的可能原因。方法收集经术后病理证实为子宫内膜癌的患者77例和宫颈癌患者50例,并将患者的术前MRI分期和手术病理分期进行回顾性分析。结果 MRI评价子宫内膜癌Ⅰ期分期ⅠA、ⅠB的准确性分别为87.0%、92.2%,评价Ⅱ期的准确性为89.6%,评价Ⅲ期中ⅢA、ⅢB、ⅢC的诊断准确性分别为94.8%、97.4%、0,其中反映术前分期与手术病理分期一致性的总Kappa值为0.6(P<0.01)。MRI评价宫颈癌I期分期中ⅠA、ⅠB1、ⅠB2的准确性分别为98.0%、86.0%、92.0%,评价Ⅱ期中ⅡA1、ⅡA2评价诊断准确性分别为84.0%、100.0%,其中反映术前分期与手术病理分期一致性的总Kappa值为0.7(P<0.01)。MRI误判常见的原因为子宫内膜癌同时合并子宫肌瘤、子宫腺肌病、子宫内膜息肉、盆腔炎症;宫颈癌同时合并子宫肌瘤、宫颈息肉、盆腔炎症。结论MRI能较好的对子宫内膜癌和宫颈癌进行评估,当有淋巴结转移时预测准确性明显下降。子宫内膜癌同时合并子宫肌瘤、子宫腺肌病、子宫内膜息肉、盆腔炎症,宫颈癌同时合并子宫肌瘤、宫颈息肉、盆腔炎症时误判可能性大。
Objective To evaluate the application of MRI in the assessment of staging of cervical cancer and endometrial cancer and analyze the misdiagnostic factors. Methods 77 endometrial cancer cases and 50 cervical cancer cases were studied retrospectively. All cases underwent MRI scan before operation, MRI staging was compared with surgicopathologic staging. Results The accuracy rates of Ⅰ A and Ⅰ B stage were 87.0% and 92.2% ,which were achieved by MRI in endometrial cancer. The accuracy rate of Ⅱ stage was 89.6%. The accuracy rates of Ⅲ A, Ⅲ B and Ⅲ C stage were 94. 8% , 97.4% , 0, and Kappa value of MRI in identifying the consistency was 0.6 （ P 〈 0.01）. The accuracy rates of Ⅰ A, Ⅰ B1 and Ⅰ B2 stage were 98.0% ,86.0% ,92.0% , which were achieved by MRI in cervical cancer. The accuracy rates of Ⅱ A1,Ⅱ A2 stage were 84. 0% , 100. 0% , and Kappa value of MRI in identifying the consistency was 0. 7 （P 〈 0. 01 ）. MRI was often misinterpreted, main reasons were that endometrial cancer remained with uterine fibroids, adenomyosis, endometrial polyps, pelvic inflammation disease and cervical cancer was mixed with uterine fibroids, cervical polyp, pelvic inflammation disease. Conclusion MRI has a good evaluation in endometrial cancer and cervical cancer. When the lymph node metastasize, the prediction feature significantly decrease. Endometrial cancer which was mixed with uterine fibroids, adenomyosis, endometrial polyps, pelvic inflammation disease and cervical cancer which is mixed with uterine fibroids, cervical polyp, pelvic inflammation disease, are both often misinterpreted.
出处
《安徽医科大学学报》
CAS
北大核心
2016年第11期1642-1646,共5页
Acta Universitatis Medicinalis Anhui
基金
安徽医科大学第一附属医院国家自然科学基金青年基金培育计划(编号:2011KJ03)
关键词
妇科恶性肿瘤
术前分期
MRI成像
误判原因
gynecologic malignancies tumor
pre -operation stage
MRI imaging
misjudgement factors
