【摘要】 目的探讨多模态核磁共振检查(MRI)对宫颈癌患者的疾病分期级淋巴结转移情况的诊断价值。方法选择本院2018年1月至2020年12月期间收治的诊断为宫颈癌的患者46例,所有患者通过术后病理学检查后确诊。以病理学检查结果为标准进行疾病FIGO分期和淋巴结转移的判定,采用多模态MRI检查,完成常规MRI平扫、弥散加权成像(DWI)以及动态增强扫描(DCE),对比多模态MRI分期结果和淋巴结转移情况与病理结果,判断多模态MRI检测宫颈癌患者的诊断价值。结果根据术后病理学检查结果的分期为Ⅰ期患者占26.1%(12/46),Ⅱ期患者占43.5%(20/46),Ⅲ期患者占17.4%(8/46),Ⅳ期患者占10.9%(5/46)。多模态MRI检查分期结果为Ⅰ期13例,Ⅱ期为18例,Ⅲ期为10例,Ⅳ为5例;与术后病理检查结果对比后,多模态MRI对Ⅳ期宫颈癌患者的诊断准确性、敏感性、特异性、阳性预测值、阴性预测值均为100.00%,高于Ⅲ、Ⅱ、Ⅰ期宫颈癌诊断(P<0.05)。46例患者经过手术共检查131个淋巴结,其中63个淋巴结发生转移,68个淋巴结未发生转移,多模态MRI检查后诊断有60个淋巴结出现转移,诊断的准确性为93.1%,诊断的敏感性为95.00%,诊断特异性为91.56%。结论多模态MRI检查对宫颈癌患者的疾病分期和淋巴结转移情况的诊断具有较高的准确性,能够清晰全面的显示病灶情况,有效识别疾病分期,可作为宫颈癌诊断的重要手段,值得临床推广。更多还原

【Abstract】 Objective To explore the diagnostic value of multimodal magnetic resonance imaging(MRI)in cervical cancer patients with stage-by-stage lymph node metastasis. Methods 46 patients with cervical cancer diagnosed in our hospital from January 2017 to June 2019 were selected. All patients were confirmed by pathological examination after operation. The FIGO staging and lymph node metastasis of cervical cancer were determined according to pathological examination results. Conventional MRI plain scan,diffusion-weighted imaging(DWI)and dynamic contrast-enhanced scanning(DCE)were performed by multi-modal MRI.The diagnostic value of multi-modal MRI in detecting cervical cancer patients was evaluated by comparing the staging results of multi-modal MRI and lymph node metastasis with pathological results. Results According to the results of postoperative pathology,26.1%(12/46)of stageⅠpatients,43.5%(20/46)of stageⅡ,17.4%(8/46)of stageⅢ,and stageⅣ10.9%(5/46). The results of multimodal MRI examination were 13 cases in stageⅠ,18 cases in stageⅡ,10 cases in stageⅢ,and 5 cases in stageⅣ. Compared with the results of postoperative pathological examination,multimodal MRI showed the diagnosis of stageⅣcervical cancer. The diagnostic accuracy,sensitivity,specificity,positive predictive value,and negative predictive value were all 100.00%,which was higher than the diagnosis of stageⅢ,ⅡandⅠcervical cancer(P<0.05). A total of 131 lymph nodes were examined in 46 patients after surgery,of which 63 lymph nodes had metastasis and 68 lymph nodes had no metastasis. After multimodal MRI,60 lymph nodes were diagnosed with metastasis. The accuracy of diagnosis was 93.1%,and the diagnosis was sensitive. The sensitivity of diagnosis was95.00%,and the specificity of diagnosis was 91.56%. Conclusion Multimodal MRI examination has high accuracy in the diagnosis of cervical cancer staging and lymph node metastasis. It can clearly and comprehensively display the lesion and effectively identify the disease staging. It is worthy of clinical promotion.更多还原