磁共振扩散加权成像及动态增强扫描在宫颈癌分期中的应用

摘要

目的:探讨常规MRI联合扩散加权成像(DWI)和动态增强(DCE) MRI在宫颈癌诊断及分期中的价值.方法:35例经手术病理或活检证实的宫颈癌患者按临床治疗方式分为手术组(20例)和非手术组(15例),以病理及临床分期为参照,评估常规MRI联合DWI、DCE-MRI(多模态MRI)对宫颈癌的分期诊断准确性.结果:手术组中常规MRI和多模态MRI对宫颈癌分期诊断符合率分别为80％(16/20)和95％(19/20).术后病理证实盆腔淋巴结转移4例,MRI检出3例.非手术组中多模态MRI分期与临床分期符合率为67％(10/15).结论:常规MRI联合DWI和DCE MRI可提高对宫颈癌分期的准确性,有助于宫颈癌治疗方案的制定.%Objective:The aim of the present study was to explore the application value of conventional MRI combined with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) in the diagnosis and staging of cervical carcinoma.Methods:Thirty-five female patients with cervical carcinoma confirmed by post-surgery pathology or cervical biopsy were divided into two groups according to treatment methods:surgery group (n 20) and non-surgery group (n=15).Taking the pathologic or clinical staging as the standard,the diagnostic and staging accuracy of conventional MRI combined with DWI and DCE-MRI (namely multimodal MRI) was evaluated.Results:In the surgery group,the staging accuracy of conventional MRI and multimodal MRI was 80 ％ (16/20) and 95 ％ (19/20),respectively.There were metastases in pelvic lymph nodes confirmed by post-operative pathology in four cases,and three of them were detected by MRI.In the non-surgery group,the staging accuracy of multimodal MRI was 67％ (10/15).Conclusion:Conventional MRI combined with DWI and DCE-MRI can be helpful to improve the preoperative staging accuracy of cervical carcinoma.