对比MRI与经阴道彩色多普勒超声用于早期宫颈癌术前评估的价值
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摘要
目的对比MRI与经阴道彩色多普勒超声用于早期宫颈癌术前评估的价值。方法随机选取2015年5月至2017年5月邢台市第三医院诊治的早期宫颈癌患者70例作为研究对象,所有患者均接受TVUS与MRI检查,术后均送组织进行病理检查,对TVUS、MRI、TVUS+MRI与手术病理诊断对照进行统计分析。结果 TVUS+MRI诊断肿瘤直径≤2cm、间质浸润≤1/2、淋巴结转移、阴道受侵、宫旁浸润的灵敏度、特异度、准确率、阳性预测值、阴性预测值均显著高于TVUS、MRI,其差异均具有统计学意义(均P<0.05),而MRI诊断阴道受侵的灵敏度、特异度、准确率、阴性预测值均显著高于TVUS,其差异均具有统计学意义(均P<0.05),阳性预测值显著低于TVUS(P<0.05),但TVUS、MRI诊断肿瘤直径≤2cm、间质浸润≤1/2、淋巴结转移、宫旁浸润的灵敏度、特异度、准确率、阳性预测值、阴性预测值之间的差异均不显著,均无统计学意义(均P>0.05)。结论 MRI与经阴道彩色多普勒超声用于早期宫颈癌术前评估的价值相当,联合检查能够显著提升诊断的准确率,值得推广。
Objective To compare the values of MRI and transvaginal color Doppler ultrasonography in the preoperative evaluation of early cervical cancer. Methods 70 cases of patients with early cervical cancer in our hospital from May 2015 to May 2017 were selected, all patients received TVUS and MRI examinations, all the tissues were sent for pathological examination, the TVUS, MRI, TVUS+MRI and operation pathology diagnosis were statistically analyzed. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TVUS+MRI in the diagnosis of tumor diameter less than 2 cm, stromal invasion, lymph node metastasis, 1/2 vaginal invasion, parametrial infiltration were significantly higher than TVUS, MRI(all P<0.05), and the the sensitivity, specificity, accuracy rate and negative predictive value of MRI in the diagnosis of vaginal invasion were significantly higher than TVUS(all P<0.05), the positive predictive value was significantly lower than TVUS(P<0.05), but the differences of sensitivity, specificity, accuracy, positive predictive value and negative predictive value between TVUS and MRI in the diagnosis of tumor diameter less than 2 cm, less than 1/2, interstitial infiltration of lymph node metastasis, parametrial infiltration were not significant(all P >0.05). Conclusions The value of MRI and transvaginal color Doppler ultrasound in the preoperative evaluation of early cervical cancer is equivalent, and the combined examination can significantly improve the accuracy of diagnosis, so is worthy of promotion.
Objective To compare the values of MRI and transvaginal color Doppler ultrasonography in the preoperative evaluation of early cervical cancer. Methods 70 cases of patients with early cervical cancer in our hospital from May 2015 to May 2017 were selected, all patients received TVUS and MRI examinations, all the tissues were sent for pathological examination, the TVUS, MRI, TVUS+MRI and operation pathology diagnosis were statistically analyzed. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TVUS+MRI in the diagnosis of tumor diameter less than 2 cm, stromal invasion, lymph node metastasis, 1/2 vaginal invasion, parametrial infiltration were significantly higher than TVUS, MRI(all P<0.05), and the the sensitivity, specificity, accuracy rate and negative predictive value of MRI in the diagnosis of vaginal invasion were significantly higher than TVUS(all P<0.05), the positive predictive value was significantly lower than TVUS(P<0.05), but the differences of sensitivity, specificity, accuracy, positive predictive value and negative predictive value between TVUS and MRI in the diagnosis of tumor diameter less than 2 cm, less than 1/2, interstitial infiltration of lymph node metastasis, parametrial infiltration were not significant(all P >0.05). Conclusions The value of MRI and transvaginal color Doppler ultrasound in the preoperative evaluation of early cervical cancer is equivalent, and the combined examination can significantly improve the accuracy of diagnosis, so is worthy of promotion.
引文
[1] 席海斌.经阴道彩色能量多普勒超声检测宫颈病变血流与MVD、EphA2 表达的相关性研究[D].太原:山西医科大学,2013.
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[7] 杨燕,茹彤,洪颖,等.经阴道彩色多普勒超声在宫颈疾病诊断中的应用及质量控制[J].东南大学学报(医学版),2014,33(2):151-153.
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[12] 宋蕾,梁慧,付敏,等.阴道三维能量多普勒超声成像技术在早期宫颈癌及癌前病变中的应用[J].医学影像学杂志,2013,23(12):1988-1991.
[13] 孙瑞瑞,胡尔西旦·尼牙孜,赵化荣,等.宫颈癌不同分期方式的优劣势及其对后续治疗的指导价值[J].现代肿瘤医学,2015,23(17):2532-2536.
[14] 芮平.HPV-DNA亚型检测联合液基细胞学对宫颈癌筛查的临床价值[J].中国性科学,2012,21(7):48-50.
[15] 徐铁兵,邢春英,王维琴,等.35245例宫颈癌筛查结果分析[J].中国性科学,2012,21(4):11-14,18.
[16] Li X,Wang L,Li Y,et al.The value of diffusion-weighted imaging in combination with conventional magnetic resonance imaging for improving tumor detection for early cervical carcinoma treated with fertility-sparing surgery[J].Int J Gynecol Cancer,2017,27(8):1761-1768.
[17] Lee SW,Lee SH,Kim J,et al.Magnetic resonance imaging during definitive chemoradiotherapy can predict tumor recurrence and patient survival in locally advanced cervical cancer:A multi-institutional retrospective analysis of KROG 16-01[J].Gynecol Oncol,2017,147(2):334-339.
[18] Huang Y,Huang J,Feng M,et al.Early changes in the apparent diffusion coefficient and MMP-9 expression of a cervical carcinoma U14 allograft model following irradiation[J].Oncol Lett,2017,14(6):6769-6775.
[2] 牛亚玲,赵春刚.经阴道彩色多普勒检查病灶内微血管情况与早期宫颈癌预后的关系分析[J].医学影像学杂志,2014,24(8):1350-1353.
[3] 于晓伟,张松灵,张晓霞,等.经阴道彩色多普勒超声检查在早期宫颈癌诊治中的意义[J].中国超声医学杂志,2011,27(1):60-62.
[4] 曾云,苏建芬,王菊芳.彩色多普勒超声血流阻力指数与宫颈癌血管生成关系的研究[J].重庆医科大学学报,2013,38(2):175-178.
[5] 章文华,子宫颈癌防治展望[J].癌症进展,2010,8(2):105-108.
[6] 余秀华,施红,钱斌,等.超声造影对宫颈癌血管生成的初步研究[J].中华医学超声杂志(电子版),2010,7(7):1176-1186.
[7] 杨燕,茹彤,洪颖,等.经阴道彩色多普勒超声在宫颈疾病诊断中的应用及质量控制[J].东南大学学报(医学版),2014,33(2):151-153.
[8] 郎景和.子宫颈癌预防的现代策略[J].中国医学科学院学报,2007,29(5):575-578.
[9] 张燕利,徐秋栋,曹博.经阴道彩色多普勒超声在宫颈癌诊断中的应用[J].中国老年学杂志,2013,33(12):2773-2775.
[10] 周彦杰,周纯芝,曹味纯.彩色多普勒超声在早期宫颈癌盆腔淋巴结转移诊断中的应用[J].实用预防医学,2011,18(10):1920-1921.
[11] 耿京,唐军,赵旸,等.探讨三维能量多普勒超声在宫颈癌与重度宫颈上皮内瘤变的应用价值[J].中国妇产科临床杂志,2011,12(1):22-25.
[12] 宋蕾,梁慧,付敏,等.阴道三维能量多普勒超声成像技术在早期宫颈癌及癌前病变中的应用[J].医学影像学杂志,2013,23(12):1988-1991.
[13] 孙瑞瑞,胡尔西旦·尼牙孜,赵化荣,等.宫颈癌不同分期方式的优劣势及其对后续治疗的指导价值[J].现代肿瘤医学,2015,23(17):2532-2536.
[14] 芮平.HPV-DNA亚型检测联合液基细胞学对宫颈癌筛查的临床价值[J].中国性科学,2012,21(7):48-50.
[15] 徐铁兵,邢春英,王维琴,等.35245例宫颈癌筛查结果分析[J].中国性科学,2012,21(4):11-14,18.
[16] Li X,Wang L,Li Y,et al.The value of diffusion-weighted imaging in combination with conventional magnetic resonance imaging for improving tumor detection for early cervical carcinoma treated with fertility-sparing surgery[J].Int J Gynecol Cancer,2017,27(8):1761-1768.
[17] Lee SW,Lee SH,Kim J,et al.Magnetic resonance imaging during definitive chemoradiotherapy can predict tumor recurrence and patient survival in locally advanced cervical cancer:A multi-institutional retrospective analysis of KROG 16-01[J].Gynecol Oncol,2017,147(2):334-339.
[18] Huang Y,Huang J,Feng M,et al.Early changes in the apparent diffusion coefficient and MMP-9 expression of a cervical carcinoma U14 allograft model following irradiation[J].Oncol Lett,2017,14(6):6769-6775.