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MRI平扫及增强扫描在宫颈病变中应用研究

作者:王贤坤

所属单位:广西自治区北海市中医医院放射科(广西 北海 536000)

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摘要

 目的 研究MRI平扫及增强扫描 在宫颈病变中应用价值。方法 选取2013 年6月至2015年3月我院收治的宫颈病变 患者45例为研究对象,术前均行CT、MRI 平扫及增强扫描,观察其MRI影像特点, 并以手术病理分期为准,对比CT及MRI诊 断宫颈癌各征象的准确度,分析MRI平扫 及增强扫描诊断宫颈病变各分期的符合 率。结果 MRI平扫及增强扫描显示子宫 体积稍增大,子宫颈见不规则软组织肿 块,呈等T1等短T2信号改变、压脂呈等 信号,DWI呈高信号,边界欠清,宫体 及阴道受侵犯,增强扫描强化程度低于 正常子宫而呈稍低信号改变,盆腔、宫 腔内见长T1长T2信号影;以病理结果为 准,MRI增强扫描对宫颈癌分期Ⅰb1期 及以下的诊断符合率84.6%明显高于平 扫50.0%(P<0.05),Ⅰb-Ⅱa期、Ⅱb期 及以上的诊断符合率差异无统计学意义 (P>0.05),MRI增强扫描总分期诊断符合 率84.4%高于平扫68.9%(P<0.05)。结论 MRI平扫及增强扫描诊断宫颈癌分期的准 确度高于CT,且增强扫描后准确度明显 提高,值得在临床推广应用。

Objective To study the application value of MRI plain scan and enhanced scan in cervical lesions. Methods Forty-five patients with cervical lesions admitted in our hospital between June 2013 and March 2015 were selected as the study subjects. CT and MRI plain scan and enhanced scan were performed before operation, and the MRI findings were observed. With the surgical and pathological staging as the standard, the accuracy rates of CT and MRI in the diagnosis of signs of cervical cancer were compared, and the coincidence rates of MRI plain scan and enhanced scan in the diagnosis of different cervical cancer stages were analyzed. Results MRI plain scan and enhanced scan showed slightly increased volume of uterus, and there were irregular soft tissue masses in uterus, showing equal T1 and equal short T2 signal changes. Fat suppression showed equal signal, and DWI showed high signal. The boundaries were unclear, and the uterus and vagina were invaded. The degree of enhancement of enhanced scan was lower than that of normal uterus, showing slightly lower signal changes. Pelvic and uterine cavity showed long T1 and long T2 signal.With the pathological results as the standard, the coincidence rate of MRI in the diagnosis of cervical cancerⅠb1 stage or lower stage (84.6%) was significantly higher than that of plain scan (50.0%) (P<0.05) while there was no significant difference in the coincidence rates in the diagnosis of Ⅰb-Ⅱa, Ⅰb stage and higher stage (P>0.05). The coincidence rate of MRI enhanced scan in the diagnosis of total stage (84.4%) was higher than that of plain scan (68.9%) (P<0.05). Conclusion The accuracy of MRI plain scan and enhanced scan in the diagnosis of cervical cancer stage is higher than that of CT, and the accuracy is significantly improved after enhanced scan.

【关键词】MRI;平扫;增强扫描;宫颈 病变;价值

【中图分类号】R711.74

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.06.040

前言

宫颈癌是女性生殖系统常见病、多发病,占女性所有生殖道恶性 肿瘤66.67%,死亡率位居女性生殖道肿瘤首位,近年来宫颈癌发病率 呈上升趋势,并有年轻化趋势,因此术前充分了解宫颈癌病情对提高 术后生存率具有重要意义[1]。传统妇科检查及细胞学检查无法准确判 断肿瘤侵犯途径及范围,随影像学技术发展,宫颈癌的检出率明显提 高,其中CT具有后处理技术强大优点,而磁共振成像(MRI)因具有无创 性、对软组织分辨率高、多方位多序列成像特点而在临床广泛应用, 此外MRI增强扫描可连续观察肿瘤血供情况,正常显示肿瘤组织及正 常宫颈组织,其价值已在国外研究中得到证实,并用于评价疾病预 后[2-4]。本文选取我院收治的宫颈病变患者45例为研究对象,分析MRI 平扫及增强扫描在宫颈病变中的应用价值,现报告如下。