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目的评价MRI在宫颈癌诊断及分期中的价值。方法选择256例经病理确诊为宫颈癌的女性患者,年龄28~70岁,中位年龄46岁。术前行MRI检查,参照国际妇产科联盟(FIGO)标准进行MRI分期,将MRI分期和临床分期分别与手术病理所见对比,计算MRI诊断宫颈癌分期的准确度及判断宫旁浸润、阴道侵犯、淋巴结转移的灵敏度和特异度。结果Ⅰa期宫颈癌患者MRI检查有阳性发现者仅为50%,而Ⅰb期以上宫颈癌患者MRI检查均有阳性发现。MRI分期总准确度86.33%,临床分期总准确度84.38%。两者比较,差异无统计学意义(P>0.05)。MRI检查判断宫旁浸润、阴道侵犯、淋巴结转移的灵敏度和特异度分别为66.67%和80.00%、89.32%和91.89%、84.00%和90.32%。结论 MRI在宫颈癌的诊断和分期中有着重要价值,可以作为宫颈癌患者治疗前评估病变范围的常规检查。
Objective To evaluate the value of MRI in the diagnosis and staging of cervical cancer. Methods A total of 256 female patients with pathologically diagnosed cervical cancer were selected, aged from 28 to 70 years old, with a median age of 46 years. Preoperative MRI examination, with reference to the International Organization of Gynecology and Obstetrics (FIGO) standard MRI staging, the MRI staging and clinical staging were compared with the surgical pathology, calculate the accuracy of MRI diagnosis of cervical cancer staging and determine the uterine infiltration, the vagina Invasion, lymph node metastasis sensitivity and specificity. Results The positive findings of MRI examination in stage Ⅰa cervical cancer patients were only 50%, while those in stage Ⅰb cervical cancer patients were all positive. The total accuracy of MRI staging was 86.33% and the total accuracy of clinical staging was 84.38%. There was no significant difference between the two groups (P> 0.05). The sensitivity and specificity of MRI examination for parametrial invasion, vaginal invasion and lymph node metastasis were 66.67% and 80.00%, 89.32% and 91.89%, 84.00% and 90.32%, respectively. Conclusion MRI is of great value in the diagnosis and staging of cervical cancer. It can be used as a routine examination of cervical lesions before treatment.