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目的评估磁共振(MR)间接淋巴系统造影诊断宫颈癌前哨淋巴结及盆腔淋巴结转移的价值。方法选取2006年1月至2009年3月南京鼓楼医院收治的Ⅰa2～Ⅱa期的宫颈癌患者21例,检查前未行盆腔手术或放疗,在双足趾蹼间或外阴大小阴唇皮内或宫颈间质注射欧乃影造影剂,行MR间接淋巴造影,观察前哨淋巴结、盆腔淋巴管引流情况及淋巴结转移情况。患者均行广泛全子宫切除+盆腔淋巴清扫术。结果 21例成功行MR间接淋巴造影的宫颈癌患者中,能清晰观察到淋巴结形态及淋巴管走行。淋巴造影阳性患者4例,术后病理淋巴结为阳性,1例造影示右腹股沟深淋巴结转移,术后病理为右髂内淋巴结转移;阴性17例,16例术后病理淋巴结检查结果阴性,1例假阴性的病理示左闭孔淋巴结有1/1转移。结论对宫颈癌患者行MR间接淋巴造影可有效显示盆腔引流区域淋巴管、淋巴结的解剖形态,评价前哨淋巴结状态及诊断宫颈癌淋巴是否转移是可行的。
Objective To evaluate the value of magnetic resonance (MR) indirect lymph system angiography in the diagnosis of cervical cancer sentinel lymph node and pelvic lymph node metastasis. Methods Twenty-one patients with stageⅠa2 ~ Ⅱa cervical cancer who were treated in Nanjing Drum Tower Hospital from January 2006 to March 2009 were selected. No pelvic surgery or radiotherapy was performed before the examination. The interlabellar or vulvar labial or labial cervix Quality injection of canine shadow contrast agent, MR indirect lymphography, observed sentinel lymph node, pelvic lymphatic drainage and lymph node metastasis. Patients underwent extensive hysterectomy + pelvic lymphadenectomy. Results Twenty-one patients with cervical cancer who underwent MR indirect lymphography were able to clearly observe the lymph node morphology and lymphatic vessels. Four patients with positive lymphadenectomy showed positive postoperative pathological lymph nodes, one with deep inguinal lymph node metastasis and the right path with lymph node metastasis in the right inguinal region. The negative results were negative in 17 cases, negative results in 16 cases of postoperative pathological lymph nodes, and false negative in 1 case Pathology showed left obturator lymph nodes have 1/1 metastasis. Conclusion MR indirect lymphadenectomy in patients with cervical cancer can effectively display the anatomy of lymphatic vessels and lymph nodes in pelvic drainage area, evaluate the status of sentinel lymph nodes and diagnose the metastasis of cervical lymph nodes is feasible.