MRI对浸润性宫颈癌术前分期及宫旁浸润、阴道受侵、淋巴结转移的诊断价值OA
Diagnostic Value of MRI in Preoperative Staging,Parametrial Invasion,Vagi-nal Involvement and Lymph Node Metastasis of Invasive Cervical Cancer
目的 分析磁共振成像(MRI)对浸润性宫颈癌术前分期及宫旁浸润、阴道受侵、淋巴结转移的诊断价值.方法 回顾性选取2024年1月至2026年2月在我院就诊并行手术治疗的168例浸润性宫颈癌患者作为研究对象,所有患者术前均完成盆腔MRI平扫及动态增强扫描检查.以术后病理诊断结果为金标准,计算MRI术前分期总符合率,采用Kappa检验评价MRI术前分期与术后病理分期的一致性;统计并分析MRI诊断宫旁浸润、阴道受侵及淋巴结转移的灵敏度、特异度与准确度.结果 168例患者术后病理分期证实Ⅰ B期58例、ⅡA期38例、ⅡB期39例、ⅢA期10例、ⅢB期15例、ⅣA期8例,MRI术前诊断分期:ⅠB期60例、ⅡA期37例、ⅡB期39例、ⅢA期13例、ⅢB期13例、ⅣA期6例,诊断总符合率为85.12％(143/168);一致性检验结果显示,MRI术前分期诊断结果与术后病理组织检查结果一致性较高(Kappa值=0.804,P＜0.05).术后病理证实168例患者中宫旁浸润45例、阴道受侵27例、淋巴结转移25例.MRI术前诊断出宫旁浸润47例、阴道受侵31例、淋巴结转移27例.MRI诊断宫旁浸润的灵敏度、特异度及准确度分别为71.11％、87.80％、83.33％;MRI诊断阴道受侵的灵敏度、特异度及准确度分别为74.07％、92.20％、89.29％;MRI诊断淋巴结转移的灵敏度、特异度及准确度分别为72.00％、93.71％、90.48％.结论 MRI对浸润性宫颈癌术前分期诊断的准确性较高,并可有效评估宫旁浸润、阴道受侵及淋巴结转移情况,临床应用价值较高.
Objective To analyze the diagnostic value of magnetic resonance imaging(MRI)in preoperative staging,parametrial invasion,vaginal involvement and lymph node metastasis of invasive cervical cancer.Methods A total of 168 patients with invasive cervical cancer who received surgical treatment in our hospital from January 2024 to February 2026 were retrospectively enrolled as research subjects.All patients completed pelvic MRI plain scan and dynamic contrast-enhanced scan before surgery.Taking postoperative pathological diagnosis as the gold standard,the overall concordance rate of MRI preoperative staging was calculated.Kappa test was adopted to assess the consistency between MRI preoperative staging and postoperative pathological staging.The sensitivity,specificity and accuracy of MRI for diagnosing parametrial invasion,vaginal involvement and lymph node metastasis were statistically analyzed.Results Postoperative pathological staging of the 168 patients confirmed 58 cases of stage ⅠB,38 cases of stage ⅡA,39 cases of stage ⅡB,10 cases of stage ⅢA,15 cases of stage ⅢB,and 8 cases of stage ⅣA.MRI preoperative staging diagnosed 60 cases of stage ⅠB,37 cases of stage ⅡA,39 cases of stage ⅡB,13 cases of stage Ⅲ A,13 cases of stage Ⅲ B,and 6 cases of stage ⅣA.The overall staging accuracy was 85.12％(143/168).Consistency analysis showed high agreement between MRI preoperative staging and postoperative pathological examination results(Kappa value=0.804,P＜0.05).Postoperative pathology confirmed parametrial invasion in 45 cases,vaginal involvement in 27 cases,and lymph node metastasis in 25 cases among the 168 patients.MRI preoperatively detected parametrial invasion in 47 cases,vaginal involvement in 31 cases,and lymph node metastasis in 27 cases.The sensitivity,specificity,and accuracy of MRI for diagnosing parametrial invasion were 71.11％,87.80％,and 83.33％,respectively;for vaginal involvement,the values were 74.07％,92.20％,and 89.29％,respectively;and for lymph node metastasis,the values were 72.00％,93.71％,and 90.48％,respectively.Conclusions MRI has high accuracy in preoperative staging of invasive cervical cancer and can effectively evaluate parametrial invasion,vaginal involvement,and lymph node metastasis,indicating high clinical application value.
石芝彤;倪珊
兰州市第一人民医院影像中心,甘肃兰州 730050兰州市第一人民医院影像中心,甘肃兰州 730050
医药卫生
浸润性宫颈癌磁共振成像术前分期宫旁浸润阴道受侵淋巴结转移诊断价值
Invasive cervical cancerMagnetic resonance imagingPreoperative stagingParametrial invasionVaginal involve-mentLymph node metastasisDiagnostic value
《临床医学工程》 2026 (9)
1005-1009,5
甘肃省科技计划项目(项目编号:23JRRA1456)
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