摘要
目的探讨多层螺旋CT(MSCT)、磁共振成像(MRI)在浸润性宫颈癌术前分期的临床价值。方法选取60例浸润性宫颈癌患者为研究对象,患者均行MSCT、MRI进行检查,其中病理学诊断结果作为浸润性宫颈癌检查的金标准,比较MSCT、MRI对术前分期的诊断符合率,并分析其图像表现。结果MRI诊断阴道浸润准确率高于MSCT,而MSCT诊断子宫体侵犯、盆腔淋巴结转移的准确率高于MRI(P<0.05);经术后病理分期确诊,A期20例,B期28例,C期12例;分析MSCT的图像表现,可见宫颈有不同程度的增大,宫旁可见增粗的条索状影,病灶范围可见超过子宫颈间质环。大部分患者输尿管末段均显示模糊的脂肪间隙,且盆壁被侵犯。部分患者直肠、膀胱受到侵犯,扫描可见直肠、膀胱增厚;脏器壁厚度增加,不均匀,肿瘤向直肠突出;部分淋巴结转移患者,可见淋巴结增大,且边缘不清晰;增强扫描时,可见病灶中心有低密度区。分析MRI的图像表现,可见T2WI序列扫描时有不规则肿块、稍高信号,与正常宫颈相比,病灶区域呈等信号,且界限模糊;B期患者可见累及宫颈外,同时可见低信号基质环被中断,突出部分显示中等高信号;周围脂肪间隙可见高信号,且有条索影;DWI序列扫描时,多伴有局限性高信号;较毗邻组织相比,其ADC值更小。结论MSCT、MRI对浸润性宫颈癌均有较高的诊断价值,各具优势及不足,在评估术前分期方面,MRI的诊断价值较MSCT更高,具有一定优势。
Objective To investigate the clinical value of multi-slice spiral CT(MSCT)and magnetic resonance imaging(MRI)in preoperative staging of invasive cervical cancer.Methods A total of 60 patients with invasive cervical cancer were selected as the study objects,all of whom were examined by MSCT and MRI.Pathological diagnosis results were used as the gold standard for invasive cervical cancer examination.The diagnostic coincidence rate of MSCT and MRI for preoperative staging was compared,and the image manifestations were analyzed.Results The accuracy of MRI in the diagnosis of vaginal infiltration was higher than that of MSCT,while the accuracy of MSCT in the diagnosis of uterine body invasion and pelvic lymph node metastasis was higher than that of MRI(P<0.05).There were 20 cases of stage A,28 cases of stage B and 12 cases of stage C.Analysis of the MSCT image showed that the cervix had varying degrees of enlargement,and a thickened cordlike shadow could be seen near the uterus,and the lesion scope could be seen beyond the cervical interstitial ring.In most patients,the end of the ureter showed a blurred fat space and the pelvic wall was invaded.The rectum and bladder were invaded in some patients,and the scan showed thickening of rectum and bladder.The thickness of the organ wall increased and was uneven,and the tumor protruded into the rectum.In some patients with lymph node metastasis,the lymph nodes were enlarged and the edges were not clear.On enhanced scan,there was a low density area in the center of the lesion.According to the analysis of MRI images,it can be seen that there were irregular masses and slightly higher signals in T2wI sequence scan.Compared with normal cervix,the lesion area showed equal signals and blurred boundaries.In stage B patients,extratervix involvement can be seen,while the low signal matrix ring is interrupted,and the protruding part shows moderately high signal.High signal was seen in the peripheral adipose space,and there was a shadow.DWI serial scanning is usually accompanied by hig
作者
王波
秦波
Wang Bo;Qin Bo(Imaging Department,Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou 221000,China)
出处
《实用妇科内分泌电子杂志》
2023年第29期104-106,共3页
Electronic Journal of Practical Gynecological Endocrinology
关键词
浸润性宫颈癌
多层螺旋CT
磁共振成像
术前分期
Invasive cervical cancer
Multislice spiral CT
Magnetic resonance imaging
Preoperative staging
