MRI在宫颈癌分期及淋巴结转移评估中的价值探讨
目的比较宫颈癌磁共振成像（MRI）分期与2009版国际妇产科联盟（FIGO）分期的准确度并评估MRI诊断淋巴结转移的价值。方法以手术病理为金标准，比较86例宫颈癌病例（手术病理分期≥Ⅰb期）MRI分期与FIGO分期的准确度；取横断面扩散加权成像（DWI）呈稍高信号，图像上短径≥1cm的淋巴结为转移淋巴结，分析其特征并评估MRI诊断淋巴结转移的准确度、敏感度、特异度、阳性预测值、阴性预测值及转移基本特征。结果FIGO分期准确度80.2%（69/86），MRI分期准确度83.7%（72/86），差异无统计学意义（P>0.05）；MRI诊断淋巴结转移准确度94.2%（81/86）、敏感...
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| Published in | 天津医药 Vol. 44; no. 8; pp. 1022 - 1025 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
天津市中心妇产科医院放射科 邮编300100
2016
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0253-9896 |
| DOI | 10.11958/20150338 |
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| Abstract | 目的比较宫颈癌磁共振成像（MRI）分期与2009版国际妇产科联盟（FIGO）分期的准确度并评估MRI诊断淋巴结转移的价值。方法以手术病理为金标准，比较86例宫颈癌病例（手术病理分期≥Ⅰb期）MRI分期与FIGO分期的准确度；取横断面扩散加权成像（DWI）呈稍高信号，图像上短径≥1cm的淋巴结为转移淋巴结，分析其特征并评估MRI诊断淋巴结转移的准确度、敏感度、特异度、阳性预测值、阴性预测值及转移基本特征。结果FIGO分期准确度80.2%（69/86），MRI分期准确度83.7%（72/86），差异无统计学意义（P>0.05）；MRI诊断淋巴结转移准确度94.2%（81/86）、敏感度73.3%（11/15）、特异度98.6%（70/71）、阳性预测值91.7%（11/12）及阴性预测值94.6%（70/74）；11例真阳性淋巴结转移以左髂内及左髂总淋巴结为主，平均短、长直径比0.76，包括3例类圆形，3例边界不规则形，4例巨大融合形，1例含中心坏死区。1例假阳性位于右髂内淋巴结，T2WI/TRA呈巨大融合形，薄层扫描显示外形较细碎，而T2WI/SAG则呈长条形。结论MRI分期与FIGO分期准确度均较高，两者结合有利于提高诊断准确度；MRI能较准确诊断淋巴结转移。 |
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| AbstractList | R445.2%R711.74; 目的：比较宫颈癌磁共振成像（MRI）分期与2009版国际妇产科联盟（FIGO）分期的准确度并评估MRI诊断淋巴结转移的价值。方法以手术病理为金标准，比较86例宫颈癌病例（手术病理分期≥Ⅰb期）MRI分期与FIGO分期的准确度；取横断面扩散加权成像（DWI）呈稍高信号，图像上短径≥1 cm的淋巴结为转移淋巴结，分析其特征并评估MRI诊断淋巴结转移的准确度、敏感度、特异度、阳性预测值、阴性预测值及转移基本特征。结果FIGO分期准确度80.2%（69/86），MRI分期准确度83.7%（72/86），差异无统计学意义（P>0.05）；MRI诊断淋巴结转移准确度94.2%（81/86）、敏感度73.3%（11/15）、特异度98.6%（70/71）、阳性预测值91.7%（11/12）及阴性预测值94.6%（70/74）；11例真阳性淋巴结转移以左髂内及左髂总淋巴结为主，平均短、长直径比0.76，包括3例类圆形，3例边界不规则形，4例巨大融合形，1例含中心坏死区。1例假阳性位于右髂内淋巴结，T2WI/TRA呈巨大融合形，薄层扫描显示外形较细碎，而T2WI/SAG则呈长条形。结论 MRI分期与FIGO分期准确度均较高，两者结合有利于提高诊断准确度；MRI能较准确诊断淋巴结转移。 目的比较宫颈癌磁共振成像（MRI）分期与2009版国际妇产科联盟（FIGO）分期的准确度并评估MRI诊断淋巴结转移的价值。方法以手术病理为金标准，比较86例宫颈癌病例（手术病理分期≥Ⅰb期）MRI分期与FIGO分期的准确度；取横断面扩散加权成像（DWI）呈稍高信号，图像上短径≥1cm的淋巴结为转移淋巴结，分析其特征并评估MRI诊断淋巴结转移的准确度、敏感度、特异度、阳性预测值、阴性预测值及转移基本特征。结果FIGO分期准确度80.2%（69/86），MRI分期准确度83.7%（72/86），差异无统计学意义（P>0.05）；MRI诊断淋巴结转移准确度94.2%（81/86）、敏感度73.3%（11/15）、特异度98.6%（70/71）、阳性预测值91.7%（11/12）及阴性预测值94.6%（70/74）；11例真阳性淋巴结转移以左髂内及左髂总淋巴结为主，平均短、长直径比0.76，包括3例类圆形，3例边界不规则形，4例巨大融合形，1例含中心坏死区。1例假阳性位于右髂内淋巴结，T2WI/TRA呈巨大融合形，薄层扫描显示外形较细碎，而T2WI/SAG则呈长条形。结论MRI分期与FIGO分期准确度均较高，两者结合有利于提高诊断准确度；MRI能较准确诊断淋巴结转移。 |
| Abstract_FL | Objective To contrast the accuracy rate of nuclear magnetic resonance imaging (MRI)-staging and the International Federation of Gynecology and Obstetrics (FIGO, 2009) clinical-staging, and evaluate the value of MRI in diagnosis of lymph node metastasis in cervical cancer. Methods The surgical pathology was used as golden standard, the accuracy rates of MRI-staging and FIGO-staging were compared in 86 patients of cervical cancer (surgical pathological staging≥Ⅰb). The lymph nodes with slightly hyperintense signal in diffusion-weighted magnetic resonance imaging (DWI) and with minor axis≥1 cm in T2WI-TRA (T2 weighted imaging-transverse section) were considered as metastatic lymph nodes, the characteristics of lymphatic metastasis diagnosed by MRI were analyzed, and the accuracy rate, the sensitivity, the specificity, the positive predictive value and the negative predictive value of MRI were evaluated. Results The accuracy rate of FIGO-staging was 80.2%(69/86), and the accuracy rate of MRI-staging was 83.7%(72/86), there was no significant difference between them (P > 0.05). The accuracy rate of lymphatic metastasis diagnosed by MRI was 94.2%(81/86), the sensitivity was 73.3%(11/15), the specificity was 98.6%(70/71), the positive predictive value was 91.7%(11/12), and the negative predictive value was 94.6%(70/74). The true positive metastatic lymph nodes in 11 cases were located in the external iliac nodes or common iliac lymph nodes, the average short/long diameter was 0.76. The forms of lymph nodes were as follows:quasi-circular (n=3), border irregularity (n=3), huge fusion form (n=4), and 1 with central necrosis area. One case of false positive metastatic lymph node was located in the right external iliac node, with the sharp of huge fusion form in T2WI/TRA, comminution in T2WI-axial thin slices, and long strip in T2WI/SAG. Conclusion The accuracy rates of MRI-staging and FIGO-staging were both higher, which can diagnose lymphatic metastasis relatively accurately when they are combined together. |
| Author | 张湛;许相丰;魏刚 |
| AuthorAffiliation | 天津市中心妇产科医院放射科,300100 |
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| Author_FL | XU Xiangfeng WEI Gang ZHANG Zhan |
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| Copyright | Copyright © Wanfang Data Co. Ltd. All Rights Reserved. |
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| Keywords | 肿瘤分期 magnetic resonance imaging 淋巴转移 neoplasm staging 磁共振成像 敏感性与特异性 uterine cervical neoplasms diagnosis,differential 宫颈肿瘤 诊断,鉴别 lymphatic metastasis sensitivity and specificity |
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| Notes | uterine cervical neoplasms;magnetic resonance imaging;lymphatic metastasis;neoplasm staging;diagnosis, differential;sensitivity and specificity Objective To contrast the accuracy rate of nuclear magnetic resonance imaging (MRI)-staging and the International Federation of Gynecology and Obstetrics (FIGO, 2009) clinical-staging, and evaluate the value of MRI in diagnosis of lymph node metastasis in cervical cancer. Methods The surgical pathology was used as golden standard, the accuracy rates of MRI-staging and FIGO-staging were compared in 86 patients of cervical cancer (surgical pathological staging ≥Ⅰb). The lymph nodes with slightly hyperintense signal in diffusion-weighted magnetic resonance imaging (DWI) and with minor axis≥1 cm in T2WI-TRA (T2 weighted imaging-transverse section) were considered as metastatic lymph nodes, the characteristics of lymphatic metastasis diagnosed by MRI were analyzed, and the accuracy rate, the sensitivity, the specificity, the positive predictive value and the negative predic |
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| SubjectTerms | 宫颈肿瘤;磁共振成像;淋巴转移;肿瘤分期;诊断,鉴别;敏感性与特异性 |
| Title | MRI在宫颈癌分期及淋巴结转移评估中的价值探讨 |
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