探讨磁共振成像(MRI)在宫颈癌临床分期中的应用价值。

收集2009年9月至2011年9月本院收治的临床资料完整的宫颈癌患者92例为研究对象，年龄为29～82岁，分析其术前MRI影像特点，对比其中73例行选择性广泛性子宫切除术＋盆腔淋巴结清扫术患者的术后病理学检查结果(本研究遵循的程序符合大连医科大学附属第一医院人体试验委员会制定的伦理学标准，得到该委员会批准)。

MRI检查显示，除2例Ⅰ_A期患者外，90例异常宫颈均有提示，检出率为97.8%(90/92)，T1WI多呈低或等低信号，T2WI为高信号，增强后81例表现不同程度强化，DWI上均呈高信号影，49例宫颈基质环显示不完整、43例显示完整，盆腔淋巴结增大显示为21例。MRI与临床分期总体一致性为85.9%，对宫旁浸润、累及阴道、淋巴结转移、累及颈管阴性预测值分别为95.3%，98.2%，93.1%，78.3%；特异度分别为93.8%，83.6%，84.4%，90.4%；灵敏度分别为62.5%，83.3%，55.6%，38.1%。

MRI能清楚显示宫颈癌病灶大小、宫旁、阴道、颈管受累程度及增大的盆腔淋巴结，在宫颈癌临床分期诊断上具有明显指导价值，可作为宫颈癌特别是浸润性宫颈癌的首选检查方法。

To evaluate applied value of magnetic resonance imaging (MRI) in the clinical stage of cervical cancer.

From September 2009 to September 2011, a total of 92 cases (29- to 82-year-old) of cervical cancer with completely clinical data were included into this study. The results of MRI before surgery were analyzed. Among those 92 cases, 73 of them received selective radical hysterectomy + pelvic lymph node dissection. The pathological and MRI results were compared. Informed consent was obtained from all participates.

MRI could show the cervical cancer in all cases with the exception of only 2 cases of Ⅰ_A stage. Positive rate was 97.8%(90/92). The tumor was represented by isointensity and hypo intensity on T1-weighted MR images and hyper intensity on T2-weighted MR images. After bolus intravenous GD-DTPA injection, varied enhancement presented in 81 cases, the tumor was hyper intensity on DWI. The cervical stoma of 49 cases showed incompletely, 43 cases completely. A total of 21 cases of enlarged pelvic node were well shown. MRI had an accuracy of 85.9% in clinical stage diagnosis. The negative predictive value of parametrical invasion, vaginal invasion, metastasis of lymph nodes and cervical cannel invasion for MRI were 95.3%, 98.2%, 93.1%, 78.3%, respectively. The specificity were 93.8%, 83.6%, 84.4%, 90.4%, respectively. The sensitivity were 62.5%, 83.3%, 55.6%, 38.1%, respectively.

MRI can show the location, size, signal characteristics, extension of the primary tumor and parametrical tissue. MRI plays a very useful role in identifying the stages of cervical cancer, especially for invasive carcinoma. MRI can be used as the first choice method for clinical stage of cervical cancer.