【摘要】 目的探讨多模态磁共振检查在宫颈癌分期诊断中的应用价值。方法回顾性分析156例经临床证实的宫颈癌患者的术前MRI资料,按照MRI平扫、平扫联合DWI、平扫联合DCE-MRI、多模态组(平扫+DWI+DCE-MRI)进行分组,由两位有经验的放射科医师进行独立阅片并进行影像学诊断及分期,所有分期结果与最终临床分期进行对照。结果平扫准确判断分期112例,错误分期44例,诊断准确率为71.8%;平扫结合DWI准确判断分期135例,错误分期21例,诊断准确率为86.5%;平扫结合DCE-MRI准确判断分期132例,错误分期24例,诊断准确率为84.6%;多模态组准确判断分期149例,错误分期7例,诊断准确率为95.5%。四组之间的诊断准确率不全相等(P<0.05);组间比较揭示平扫联合DWI、平扫联合DCE-MRI二者之间在宫颈癌分期诊断准确率上无明显差异(P>0.05),二者分期诊断价值高于单一平扫(P<0.05)而低于多模态组(P<0.05)。结论多模态MRI检查在宫颈癌分期诊断中较单一或者二者联合检查具有更高的诊断价值,可明显提高宫颈癌分期诊断的准确率,可以作为宫颈癌分期诊断的常规有效检查手段。更多还原

【Abstract】 Objective To evaluate the value of the application of multi-modal MRI in diagnosis of staging of cervical cancer. Methods 156 cases of cervical cancer confirmed by clinic who underwent pretreatment magnetic resonance imaging were analyzed retrospectively. The MRI images were divided into 4 groups: plain scan group, plain scan combined with DWI group, plain scan combined with DCE-MRI group, and multi-modal MRI(including plain scan, DWI and DCE-MRI) group. Two experienced radiologists independently read the images and made imaging diagnosis and staging. All staging results were compared with the final clinical staging. Results Plain scan group showed accurate staging in 112 cases and false staging in 44 cases, with a diagnostic accuracy rate of 71.8%. The staging was accurately determined by plain scan combined with DWI in 135 cases, and the staging was false in 21 cases, the diagnostic accuracy rate was 86.5%. Plain scan combined with DCE-MRI accurately determined staging in 132 cases and false staging in 24 cases, with a diagnostic accuracy rate of 84.6%. Multi-modal MRI accurately determined the staging in 149 cases and the false staging in 7 cases, with a diagnostic accuracy rate of 95.5%. Statistics showed that the diagnostic accuracy was not all equal between the four groups(P<0.05). Comparison between the two groups revealed no statistically significant difference in the accuracy of cervical cancer staging between plain scan combined with DWI group and plain scan combined with DCE-MRI group, their value in the staging diagnosis was higher than that of single plain scan(P<0.05) and lower than that of multi-modal group(P<0.05). Conclusion Multi-modal MRI has higher diagnostic value than single or combined examination in the staging diagnosis of cervical cancer, can significantly improve the accuracy of cervical cancer staging diagnosis, and can be used as a routine and effective means of cervical cancer staging diagnosis.更多还原