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目的 :探讨宫颈癌的MRI表现与分期 ,并评价其诊断价值及临床意义。方法 :对 70例经病理证实的宫颈癌患者的MRI表现、诊断及分期与手术及临床作了对照分析 ,其中鳞癌 6 1例 ,腺癌 7例 ,腺鳞癌 2例 ;年龄 2 3～ 85岁。MRI扫描序列如下 :轴位T1WISE ,轴位及矢状位T2 WITSE ,冠状T2 WISPIR ,及Gd DTPA增强后的轴、矢、冠状面T1WISE。结果 :( 1)所有扫描序列中 ,以T2 WI观察效果最好 ,宫颈癌组织通常呈均匀或不均匀稍高信号 ,而正常宫颈基质呈低信号 ,宫颈内膜及粘液与宫旁脂肪呈明显高信号 ;三者之间具有良好的对比噪声比 (CNR)。( 2 )MRI对判断肿瘤部位、大小、侵犯范围及有无盆腔淋巴结转移意义重大。 ( 3) 70例宫颈癌患者分期结果为 :Ⅰb2例 ,Ⅱa 2例 ,Ⅱb 39例 ,Ⅲa 3例 ,Ⅲb 10例 ,Ⅳa 11例 ,Ⅳb 3例。结论 :MRI可清晰显示宫颈癌的准确部位、大小及侵犯范围 ,分期客观准确 ,对临床制订治疗方案及预后评估有重要意义 ,并且是无放射性检查方法 ,建议对宫颈癌患者行常规MRI检查。
Objective: To investigate the MRI findings and staging of cervical cancer and to evaluate its diagnostic value and clinical significance. Methods: The MRI findings, diagnosis and staging of 70 cases of pathologically confirmed cervical cancer were compared with those of surgery and clinic, including 61 cases of squamous cell carcinoma, 7 cases of adenocarcinoma and 2 cases of adenosquamous carcinoma; 85 years old. MRI scan sequence is as follows: axial T1WISE, axial and sagittal T2 WITSE, coronary T2 WISPIR, and Gd DTPA enhanced axial, sagittal and coronal T1WISE. Results: (1) In all the scan sequences, T2WI was the best, cervix cancer tissue was usually uniform or slightly uneven signal, while the normal cervical stroma was low signal, cervical endometrium and mucous and palata fat were significantly High signal; a good contrast between the three noise ratio (CNR). (2) MRI is of great significance to determine the location of tumor, size, extent of invasion and pelvic lymph node metastasis. (3) 70 cases of cervical cancer staging results were: Ⅰ b2 cases, Ⅱ a 2 cases, Ⅱ b 39 cases, Ⅲ a 3 cases, Ⅲ b 10 cases, Ⅳ a 11 cases, Ⅳ b 3 cases. Conclusion: MRI can clearly show the exact location of cervical cancer, size and scope of invasion, objective and accurate stages of the clinical development of treatment programs and prognostic evaluation of great significance, and is a non-radioactive examination, cervical cancer patients recommended routine MRI examination.