3.0T磁共振及弥散加权成像对宫颈癌术前评估的临床价值研究
|
摘要
目的探讨3.0T磁共振弥散加权成像对宫颈癌分期的临床价值。方法选取2016年6月～2018年12月我院收治的71例排除不符合入组条件的宫颈癌患者作为研究对象。观察对比符合以宫颈癌国际妇产科联盟(FIGO)2009分期为金标准的临床术后病理结果与MR平扫及DWI检查中的宫颈癌分期等指标的一致性,观察磁共振成像在诊断宫颈癌的特异性、灵敏性及准确性。结果术前MR常规序列检查联合DWI扫描评估宫颈癌术前分期与术后病理结果比较:以手术及病理诊断分期为金标准,术前MR常规序列检查联合DWI功能成像诊断宫颈癌分期准确性为87.5%(63/71),与病理检查有很高的一致性(Kappa=0.89,P<0.05);术前MR常规序列检查联合DWI扫描评估宫颈癌术前分期与术后病理结果分析:对于Ⅰ期、Ⅱ期、Ⅲ期及Ⅳ期分期其各期准确性、特异性及灵敏性均在80%以上,其中Ⅳ期诊断三项指标达100.00%。结论 3.0 T磁共振弥散加权成像对于宫颈癌诊断、分期辅具有较高的临床价值,为临床治疗方案的选择提供可靠的参考依据,值得临床进行推广应用。
Objective To investigate the clinical value of 3.0 T magnetic resonance diffusion weighted imaging in staging of cervical cancer. Methods 71 patients with cervical cancer admitted in our hospital from June 2016 to December2018 were selected as subjects, excluding those who did not meet the enrollment criteria. The consistency of clinical postoperative pathological results which were in line with International Federation of Gynecology and Obstetrics of cervical cancer(FIGO) 2009 staging as the gold standard with the indexes of cervical cancer staging in MR plain scan and DWI was observed and compared. The specificity, sensitivity and accuracy of magnetic resonance imaging in diagnosing cervical cancer were observed. Results The preoperative staging of cervical cancer evaluated by preoperative MR routine sequence examination combined with DWI scan was compared with postoperative pathological results. Choosing surgical and pathological diagnosis staging as the gold standard, the accuracy of preoperative MR routine sequence test combined with DWI functional imaging in diagnosing cervical staging was 87.5%(63/71), with high consistency with pathological examination(Kappa=0.89, P<0.05). Preoperative MR routine sequence examination combined with DWI scan to evaluate preoperative staging and postoperative pathological results of cervical cancer was analyzed. The accuracy,specificity and sensitivity of stage Ⅰ, stage Ⅱ, stage Ⅲ and stage Ⅳ were all above 80%, of which the three indicators of phase Ⅳ diagnosis reached 100.00%. Conclusion 3.0 T magnetic resonance diffusion-weighted imaging has a high clinical value for the diagnosis and staging of cervical cancer, and provides a reliable reference for the selection of clinical treatment options. It is worthy of clinical application.
Objective To investigate the clinical value of 3.0 T magnetic resonance diffusion weighted imaging in staging of cervical cancer. Methods 71 patients with cervical cancer admitted in our hospital from June 2016 to December2018 were selected as subjects, excluding those who did not meet the enrollment criteria. The consistency of clinical postoperative pathological results which were in line with International Federation of Gynecology and Obstetrics of cervical cancer(FIGO) 2009 staging as the gold standard with the indexes of cervical cancer staging in MR plain scan and DWI was observed and compared. The specificity, sensitivity and accuracy of magnetic resonance imaging in diagnosing cervical cancer were observed. Results The preoperative staging of cervical cancer evaluated by preoperative MR routine sequence examination combined with DWI scan was compared with postoperative pathological results. Choosing surgical and pathological diagnosis staging as the gold standard, the accuracy of preoperative MR routine sequence test combined with DWI functional imaging in diagnosing cervical staging was 87.5%(63/71), with high consistency with pathological examination(Kappa=0.89, P<0.05). Preoperative MR routine sequence examination combined with DWI scan to evaluate preoperative staging and postoperative pathological results of cervical cancer was analyzed. The accuracy,specificity and sensitivity of stage Ⅰ, stage Ⅱ, stage Ⅲ and stage Ⅳ were all above 80%, of which the three indicators of phase Ⅳ diagnosis reached 100.00%. Conclusion 3.0 T magnetic resonance diffusion-weighted imaging has a high clinical value for the diagnosis and staging of cervical cancer, and provides a reliable reference for the selection of clinical treatment options. It is worthy of clinical application.
引文
[1]向旭,殷洁,尤国庆,等.3.0T MRI功能成像对宫颈癌术前分期的临床价值[J].中国CT和MRI杂志,2018,16(1):114-117.
[2]张萍,董江宁,高飞,等.3.0TMRI高b值扩散加权成像在宫颈癌分期中的应用[J].实用放射学杂志,2016,32(8):1246-1249.
[3]李靖,王莉,成慧君,等.MR体素内不一致运动序列预测和评价宫颈癌放化疗效果[J].临床放射学杂志,2016,35(4):539-544.
[4]陈维.3.0T磁共振成像在老年宫颈癌术前诊断及分期中的临床意义[J].实用临床医药杂志,2017,21(3):156-157.
[5]杜汉旺,牛庆亮,武希庆,等.3.0T MR扩散加权成像在宫颈癌诊断中的应用价值[J].中国CT和MRI杂志,2017,15(1):95-97.
[6]高连华,夏平.MRI平扫结合弥散加权成像在宫颈癌诊断中的应用价值[J].医学影像学杂志,2014,24(10):1853-1856.
[7]董雪,罗娅红.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[J].放射学实践,2017,32(4):321-324.
[8]陈娟,宋化雨,王淳,等.MRI在宫颈癌患者术前临床分期和盆腔淋巴结转移诊断中的应用价值[J].中国CT和MRI杂志,2017,15(2):80-82.
[9]相世峰,王玉方,董晓雷,等.3.0T MRI在子宫颈癌诊断分期及分化程度评价中的应用价值[J].山东医药,2015,55(42):90-91.
[10]林宇宁,李辉,陈自谦,等.采用MR扩散加权成像表观扩散系数值直方图诊断Ⅰb期宫颈癌的价值[J].中华放射学杂志,2015,21(5):349-353.
[11]谢宗源,谭志斌,王志强,等.常规MRI结合动态对比增强磁共振成像在宫颈癌分期中的应用价值[J].山东医药,2018,58(21):58-60.
[12]冯传宝.早期宫颈癌FIGO分期与手术病理分期的差异性分析[J].中国现代医生,2017,55(22):100-102.
[13]李敬哲.MRI检查在宫颈癌诊断及分期中应用研究[J]当代医学,2017,24(1):59-60.
[14]刘艳.经阴道联合经腹超声检查对宫颈癌分期的临床价值(附69例分析)[J].福建医药杂志,2016,38(4):124-127.
[15]余秀华,李彩云,施红,等.常规超声联合超声造影成像对宫颈癌诊断及分期初步研究[J].临床军医杂志,2017,45(1):60-63.
[2]张萍,董江宁,高飞,等.3.0TMRI高b值扩散加权成像在宫颈癌分期中的应用[J].实用放射学杂志,2016,32(8):1246-1249.
[3]李靖,王莉,成慧君,等.MR体素内不一致运动序列预测和评价宫颈癌放化疗效果[J].临床放射学杂志,2016,35(4):539-544.
[4]陈维.3.0T磁共振成像在老年宫颈癌术前诊断及分期中的临床意义[J].实用临床医药杂志,2017,21(3):156-157.
[5]杜汉旺,牛庆亮,武希庆,等.3.0T MR扩散加权成像在宫颈癌诊断中的应用价值[J].中国CT和MRI杂志,2017,15(1):95-97.
[6]高连华,夏平.MRI平扫结合弥散加权成像在宫颈癌诊断中的应用价值[J].医学影像学杂志,2014,24(10):1853-1856.
[7]董雪,罗娅红.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[J].放射学实践,2017,32(4):321-324.
[8]陈娟,宋化雨,王淳,等.MRI在宫颈癌患者术前临床分期和盆腔淋巴结转移诊断中的应用价值[J].中国CT和MRI杂志,2017,15(2):80-82.
[9]相世峰,王玉方,董晓雷,等.3.0T MRI在子宫颈癌诊断分期及分化程度评价中的应用价值[J].山东医药,2015,55(42):90-91.
[10]林宇宁,李辉,陈自谦,等.采用MR扩散加权成像表观扩散系数值直方图诊断Ⅰb期宫颈癌的价值[J].中华放射学杂志,2015,21(5):349-353.
[11]谢宗源,谭志斌,王志强,等.常规MRI结合动态对比增强磁共振成像在宫颈癌分期中的应用价值[J].山东医药,2018,58(21):58-60.
[12]冯传宝.早期宫颈癌FIGO分期与手术病理分期的差异性分析[J].中国现代医生,2017,55(22):100-102.
[13]李敬哲.MRI检查在宫颈癌诊断及分期中应用研究[J]当代医学,2017,24(1):59-60.
[14]刘艳.经阴道联合经腹超声检查对宫颈癌分期的临床价值(附69例分析)[J].福建医药杂志,2016,38(4):124-127.
[15]余秀华,李彩云,施红,等.常规超声联合超声造影成像对宫颈癌诊断及分期初步研究[J].临床军医杂志,2017,45(1):60-63.