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目的:探讨MR成像对宫颈癌诊断及分期的应用价值。方法:128例(手术49例)经病理证实的宫颈癌患者(鳞癌119例,腺癌8例,鳞腺癌1例)行盆腔轴位SE T1WI,轴位、矢状位及冠状位FSE T2WI,轴位、矢状位及冠状位T2WI脂肪抑制(FRFSE),轴位、矢状位及冠状位T1WI脂肪抑制(FSPGR/70)Gd-DTPA增强扫描。分析宫颈癌MRI的表现及侵犯范围,49例MRI术前分期与手术、病理分期对照。结果:宫颈癌的MRI T2WI呈较高信号,T2WI宫颈癌与宫颈基质低信号及宫旁脂肪组织高信号有良好的对比,T1WI呈等或低信号,Gd-DTPA增强后T1WI呈均匀或不均匀强化,MRI对宫旁侵犯判断的准确率为87%,特异性为89%,敏感性为85%,Ⅰ~Ⅱa期宫颈癌MRI分期准确率为92%,对宫颈癌分期总的准确率为86%。结论:MRI能多方位清晰显示宫颈癌瘤灶及其侵犯范围,术前分期优于其它检查方法,理应成为宫颈癌首选的影像检查方法。
Objective: To investigate the value of MR imaging in the diagnosis and staging of cervical cancer. Methods: 128 cases (49 cases) of cervical cancer confirmed by pathology (119 cases of squamous cell carcinoma, 8 cases of adenocarcinoma and 1 case of adenocarcinoma) underwent pelvic axial SE T1WI, axial, sagittal and coronal FSE T2WI, axial, sagittal and coronal T2WI fat suppression (FRFSE), axial, sagittal and coronal T1WI fat suppression (FSPGR / 70) Gd-DTPA enhanced scan. Analysis of the performance of cervical MRI and the extent of violations, 49 cases of MRI preoperative staging and surgery, pathological staging control. Results: MRI T2WI of cervical cancer showed a higher signal, T2WI cervical cancer and cervical low signal and paraloid adipose tissue high signal is good contrast, T1WI showed equal or low signal, T1WI Gd-DTPA enhanced was uniform or uneven The accuracy rate of MRI in diagnosing uterine invasion was 87%, specificity was 89%, sensitivity was 85%, MRI staging accuracy of cervical cancer Ⅰ ~ Ⅱa was 92%, and the total accuracy of cervical cancer staging was 86%. Conclusions: MRI can clearly show cervical cancer lesions and its extent of invasion in various directions. The preoperative staging is better than other methods and should be the first choice of imaging method for cervical cancer.