目的 探讨MRI在宫颈癌术前病 情评估中的临床价值。方法 回顾性分析 59例宫颈癌初诊患者术前MRI检查宫颈 癌肌层浸润、阴道受累、宫旁浸润、淋 巴结转移的影像学资料，并与术后病理 学结果进行比较，观察比较与术后病理 分期诊断的准确性及一致性，同时探讨 MRI对宫颈癌肌层浸润、阴道受累、宫 旁浸润、淋巴结转移诊断的灵敏度、特 异度、阳性预测值、阴性预测值、准确 率。结果 以术后病理学检查为金标准， 术前MRI分期诊断与术后病理分期检查结 果一致性Kappa=0.64，P<0.001，其诊断 符合率为79.66%。术前MRI对肌层浸润、 阴道受累、宫旁浸润、淋巴结转移的灵 敏度分别为77.78%、73.91%、87.18%和 77.78%，特异度分别为98.0%、96.11%、 80.0%和94.0%，诊断准确率分别为 94.92%、81.36%、84.75%和91.53%， 且检验一致性分别为Kappa=0.794、 0.605、0.664和0.687，P<0.001。结论 MRI对于宫颈癌术前分期具有较高准确 率，且对宫颈癌肌层浸润、阴道受累、 宫旁浸润、淋巴结转移具有较高的敏感 度、特异度和准确率，MRI对宫颈癌术前 病情评估具有重要临床价值。

Objective To explore the clinical value of MRI in preoperative condition evaluation of cervical cancer. Methods The imaging data of 59 cervical cancer patients treated with preoperative MRI examination about myometrial infiltration, vaginal involvement, parametrial infiltration and lymph node metastasis were analyzed retrospectively. The postoperative pathological findings were compared with MRI examination, the accuracy and consistency of the postoperative pathological staging diagnosis were observed and compared. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI in the diagnosis of myometrial infiltration, vaginal involvement, parametrial infiltration and lymph node metastasis were also discussed. Results The pathological examination was taken as the gold standard, and the preoperative MRI staging diagnosis and the postoperative pathological staging examination were consistent with Kappa=0.64 and P<0.001, and the diagnostic accuracy rate was 79.66%. The sensitivity of MRI for preoperative myometrial infiltration, vaginal involvement, parametrial infiltration and lymph node metastasis were 77.78%, 73.91%, 87.18% and 77.78%, and the specificity were 98%, 96.11%, 80% and 94% respectively, and the accuracy rate of diagnosis were 94.92%, 81.36%, 84.75% and 91.53%, and the consistency were Kappa=0.794, 0.605 , 0.664 and 0.687, P<0.001. Conclusion MRI has a high accuracy rate for preoperative staging of cervical cancer, and has high sensitivity, specificity and accuracy to cervical myometrial infiltration, vaginal involvement, parametrial infiltration and lymph node metastasis, therefore MRI has important clinical value on cervical cancer preoperative condition evaluation.