摘要
目的探讨多模态磁共振成像(MRI)评估宫颈癌病理分期、浸润及淋巴结转移的临床价值。方法选取2017年1月1日—2022年11月21日台州市第一人民医院收治的86例宫颈癌患者作为研究对象。均接受多模态MRI检查[常规MRI序列扫描+弥散加权成像扫描(DWI)+动态对比增强MRI扫描(DCE-MRI)],以病理检查结果为金标准。比较各组的弥散系数(ADC)值、转运常数(K^(trans))、血管外细胞外间隙体积百分数(V_(e))、数率常数(K_(ep))水平变化,探讨多模态MRI检查对宫颈癌患者病理分期、浸润及淋巴结转移的评估价值。结果宫颈癌患者经多模态MRI检查的病理分期结果为Ⅰ期21例、Ⅱ期44例、Ⅲ期15例、Ⅳ期6例;86例宫颈癌患者共有22例发生浸润转移,经多模态MRI检查共发现21例浸润转移;在手术过程中共检出247个淋巴结,共有120个淋巴结发生转移,经多模态MRI检查共发现113个淋巴结转移。随着FIGO分期提高,ADC值逐渐降低,K^(trans)、V_(e)、K_(ep)水平逐渐增加(P<0.05);浸润及淋巴结转移患者的ADC值低于未发生浸润及淋巴结转移患者,K^(trans)、V_(e)、K_(ep)水平高于未发生浸润及淋巴结转移患者(P<0.05)。多模态MRI检查诊断宫颈癌患者病理分期Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期的准确度分别为86.05%、87.21%、95.35%、98.94%。多模态MRI检查诊断宫颈癌患者发生浸润转移的特异度为98.43%、灵敏度为90.91%、准确度为96.51%、阴性预测值为96.93%、阳性预测值为95.24%。多模态MRI检查诊断宫颈癌患者发生淋巴结转移的特异度为94.49%、灵敏度为88.33%、准确度为91.50%、阴性预测值为89.55%、阳性预测值为93.81%。结论多模态MRI检查的相关参数变化与宫颈癌患者的病理分期、浸润及淋巴结转移有关,且多模态MRI检查对宫颈癌病理分期、浸润及淋巴结转移具有较高的评估价值。
Objective To explore the clinical value of multimodal magnetic resonance imaging(MRI)in evaluating pathological stag-ing,invasion and lymph node metastasis of cervical cancer.Methods 86 patients with cervical cancer admitted to Taizhou First People's Hospital from January 1,2017 to November 21,2022 were selected as the subjects of this study.All patients received multimodal MRI ex-amination[conventional MRI sequence scanning+diffusion weighted apparent(DWI)+dynamic contrast enhanced MRI scanning(DCE-MRI)],with pathological examination results as the gold standard.The apparent diffusion coefficient(ADC)value,transport constant(K^(trans)),extravascular extracellular space volume percentage(V_(e)),number rate constant(K_(ep))level changes in each group were com-pared,as well as the evaluation value of multimodal MRI in pathological staging,invasion and lymph node metastasis of cervical cancer pa-tients.Results The pathological staging of cervical cancer patients by multimodal MRI was 21 cases in stage Ⅰ,44 cases in stage Ⅱ,15 cases in stage Ⅲ,and 6 cases in stage Ⅳ.In 86 cases of cervical cancer,22 cases had invasion and metastasis,and 21 cases were found by multimodal MRI.A total of 247 lymph nodes were detected during the operation,120 lymph nodes were metastasized,and 113 lymph nodes were metastasized by multimodal MRI.With the increase of FIGO staging,ADC value gradually decreased,and K^(trans),V_(e),K_(ep) levels gradually increased(P<0.05).ADC value of patients with invasion and lymph node metastasis was lower than that of patients without invasion and lymph node metastasis,and K^(trans),V_(e),K_(ep) levels were high-er than those of patients without invasion and lymph node metastasis(P<0.05).The accuracy of multimodal MRI in diagnosing stage Ⅰ,stage Ⅱ,stage Ⅲ and stage Ⅳ of cervical cancer was 86.05%,87.21%,95.35% and 98.94% respectively.The specificity,sensitivity,accuracy,negative predictive value and positive predictive value of multimodal MRI in the diagnosis of invasion and metastasis of cervical cancer were 98.43%,90.91%,96.50%,96.93% and 95.24% respectively.The specificity,sensitivity,accuracy,negative predictive value and positive predictive value of multimodal MRI in the diagnosis of cervical cancer patients with lymph node metastasis were 94.49%,88.33%,91.50%,89.55% and 93.81% respectively.Conclusion The changes of related parameters of multimodal MRI examination are related to the pathological stage,invasion and lymph node metastasis of cervical cancer patients,and multimodal MRI examination has a high evaluation value for the pathological stage,invasion and lymph node metastasis of cervical cancer.
作者
刘超
郑永飞
汪晟
郏鹏
LIU Chao;ZHENG Yong-fei;WANG Sheng;JIA Peng(Department of Radiology,Taizhou First People's Hospital,Taizhou,Zhejiang 318020,China)
出处
《中国妇幼保健》
CAS
2024年第16期3200-3204,共5页
Maternal and Child Health Care of China
基金
浙江省台州市科学技术局项目(22ywa26)。
关键词
多模态磁共振成像
宫颈癌
病理分期
浸润转移
淋巴结转移
Multimodal magnetic resonance imaging
Cervical cancer
Pathological staging
Infiltration and metastasis
Lymph node metastasis
