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目的观察比较宫颈癌磁共振成像(MRI)分期、临床及病理分期,分析MRI在宫颈癌术前分期的价值。方法 60例宫颈癌患者,将所有患者进行全面的MRI检查,宫颈癌临床分期采用国际妇产科联盟(FIGO)分期(2009年)的标准进行划分。通过双盲实验在术前划分出宫颈癌的MRI分期,并且将宫颈癌患者MRI、临床及术后病理分期进行对比。结果所有患者中,有4例ⅠA期通过MRI没有检测出,剩余56例患者通过MRI扫描显示出来,由此可知MRI的敏感度为93.3%。所有患者病灶形似椭圆形且边缘不具规则,T2WI显示对应较高信号影,T1WI显示为略低信号。经过MRI扫描的患者有25例病灶增强,所有病灶呈现不同程度不均匀性强化,有12例患者的病灶强化程度同正常子宫相似,有8例患者低于正常子宫,有5例患者略高于正常子宫。宫颈癌分期与手术病理分期比较,其中两者一致的有:ⅠB期15例、ⅡA期16例、ⅡB期5例、ⅢA期1例、ⅢB期1例;由此统计得出临床术前分期的诊断准确率为63.3%(38/60)。将宫颈癌病理分期与MRI分期比较,其中两者一致的有:ⅠB期17例、ⅡA期20例、ⅡB期11例、ⅢA期2例、ⅢB期1例;由此统计得出MRI分期的诊断准确率为85.0%(51/60)。结论 MRI在宫颈癌分期诊断的价值更高,尤其是宫颈癌的术前检测,使得整个检测过程更加安全、可靠、简便、快捷,而且提高了诊断的准确率,值得临床医疗推广应用。
Objective To compare the MRI staging, clinical and pathological stages of cervical cancer and analyze the value of MRI in the preoperative staging of cervical cancer. Methods 60 cases of cervical cancer patients, all patients with a comprehensive MRI examination, clinical staging of cervical cancer using the International Federation of Gynecology and Obstetrics (FIGO) staging (2009) standard division. The double-blind experiment was used to divide the MRI staging of cervical cancer preoperatively, and the MRI, clinical and postoperative pathological staging of cervical cancer patients were compared. Results In all patients, 4 cases of stage IA were not detected by MRI and the remaining 56 cases were shown by MRI. The sensitivity of MRI was 93.3%. All patients had oval lesions with irregular edges. T2WI showed a higher signal intensity and T1WI showed a slightly lower signal. Twenty-five patients underwent MRI scans with enhanced lesions and all lesions with varying degrees of inhomogeneity enhancement. Twelve patients had focal enhancement similar to that of normal uterus, eight patients were lower than normal uterus, and five patients were slightly higher Normal uterus. Cervical cancer staging and surgical pathological staging comparison, which the two are the same: Ⅰ B in 15 cases, Ⅱ A 16 cases, Ⅱ B 5 cases, Ⅲ A in 1 case, Ⅲ B in 1 case; thus obtained the clinical preoperative staging The diagnostic accuracy rate was 63.3% (38/60). The pathological staging of cervical cancer compared with MRI staging, of which the two are consistent: Ⅰ B period in 17 cases, Ⅱ A 20 cases, Ⅱ B 11 cases, Ⅲ A 2 cases, Ⅲ B 1 cases; the statistics obtained MRI staging The diagnostic accuracy was 85.0% (51/60). Conclusion MRI is more valuable in the diagnosis of cervical cancer staging, especially cervical cancer preoperative detection, making the entire detection process more secure, reliable, simple and faster, and improve the diagnostic accuracy, it is worth to promote clinical application.