浸润性宫颈癌术前CT及MRI诊断的临床价值对比

程亮 杨德文 徐畅 刘洋 于文龙

[摘要]目的 对比分析浸润性宫颈癌患者在手术前采用CT和MRI两种影像学技术诊断的临床价值。方法 选取2015年9月～2017年9月在我院接受手术治疗之后经病理学检验确定为浸润性宫颈癌的76例患者，根据其在手术前接受检查方式的不同分为对照组和研究组，每组38例。对照组在术前接受CT检查；研究组在术前接受MRI检查。对比两组的影像学诊断操作时间、术前诊断原因导致的纠纷事件、宫颈癌术前诊断结果与术后病理检验结果的符合率、误诊和漏诊情况。结果 研究组术前诊断原因導致的纠纷事件仅有1例（2.6%），少于对照组的8例（21.1%），差异有统计学意义（P<0.05）。研究组宫颈癌术前诊断结果与术后病理检验结果的符合率为94.7%，高于对照组的63.2%，差异有统计学意义（P<0.05）。研究组的误诊率和漏诊率均低于对照组，差异有统计学意义（P<0.05）。研究组的影像学诊断操作时间与对照组比较，差异无统计学意义（P>0.05）。结论 浸润性宫颈癌患者在手术前采用MRI技术进行诊断，虽然操作时间在一定程度上会有所延长，但其准确性更高，可以有效减少误诊和漏诊情况的发生，使由于病情诊断而导致的纠纷事件得到控制，能够为患者争取更多的有效治疗时间。

[关键词]浸润性；宫颈癌；磁共振成像；CT；诊断

[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-4721（2018）5（a）-0129-03

[Abstract]Objective To compare and analyze the clinical value of two imaging techniques of CT and MRI in preoperative diagnosis of invasive cervical cancer.Methods A total of 76 patients with invasive cervical cancer who were confirmed by pathological examination after operation in our hospital from September 2015 to September 2017 were selected and divided into the control group and the study group according to their different inspection methods before operation，there were 38 cases in each group.The control group received CT examination before operation，and the study group received MRI examination before operation.The imaging diagnosis operation time，preoperative dispute diagnosis，coincidence rate of preoperative diagnosis and postoperative pathological examination，misdiagnosis and missed diagnosis were compared between the two groups.Results The disputes caused preoperative diagnosis in the study group was only 1 cases （2.6%），which was less than 8 cases （21.1%） in the control group，with significant difference （P<0.05）.The coincidence rate of cervical cancer preoperative diagnosis and postoperative pathological examination results in the study group was 94.7%，which was higher than 63.2% in the control group，with significant difference （P<0.05）.The rate of misdiagnosis and missed diagnosis in the study group were less than that in the control group，with significant difference （P<0.05）.There was no significant difference in the time of imaging diagnosis between the two groups （P>0.05）.Conclusion Invasive cervical cancer patients who were diagnosed by MRI before surgery，although the operation time will be extended to a certain extent，but its accuracy is higher，which can effectively reduce the misdiagnosis and missed diagnosis cases，the disputes caused by disease diagnosis can be controlled，so that more effective treatment time can be obtained for patients.

[Key words]Invasive；Cervical cancer；Magnetic resonance imaging；Computed tomography；Diagnosis

浸润性宫颈癌属于女性较为常见的一种恶性肿瘤类疾病，宫颈上皮组织属于该病变的高发部位，近年来在我国该疾病的临床发病率呈现逐年上升的发展趋势，对广大患者的日常生活质量乃至生命安全都造成了较为严重的影响[1-2]。大量相关领域所进行的研究数据显示，早期浸润性宫颈癌患者在5年内的生存率水平能够达到90%以上，而当病情发展至晚期阶段患者5年内的存活率仅为10%左右，因此，早发现、早治疗对于该疾病患者病情的控制具有非常重要的意义，可以使患者的预后得到改善，使临床病死率得到有效控制[3-4]。……