Ho C M, Chien T Y, Jeng C M, Tsang Y M, Shih B Y, Chang S C
Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan R.O.C.
J Formos Med Assoc. 1992 Oct;91(10):982-90.
A prospective study was undertaken to compare magnetic resonance imaging (MRI) with computed tomography (CT) and examination under anesthesia (EUA) in staging cervical carcinoma, with special emphasis on parametrial status. Twenty patients with carcinoma of the cervix, in whom the extent of the disease was surgically confirmed, were analyzed by MRI, CT and EUA. The tumor size estimated by MRI correlated well (r = 0.79, p < 0.001) with those obtained by histopathologic measurement of the surgical specimen. Neither clinical examination nor CT could precisely estimate tumor size. The overall accuracy rate of MRI in staging carcinoma of the cervix was 75%, compared with 32% for CT staging and 55% for clinical staging. The accuracy rate of these modalities for parametrial status was 90% for MRI, 55% for CT and 82.5% for EUA. MRI accurately excluded all 20 patients with pelvic side wall, bladder and rectal involvement. In conclusion, MRI is superior to CT and EUA in assessment of the parametrium (90% vs 55% vs 82.5%, p < 0.005). From MRI, tumor size can be estimated precisely. Although a larger scale study comparing MRI and CT is needed to determine their roles, both should help in the diagnosis and selection of proper treatment for cervical carcinoma. Our preliminary report agrees with previous reports that MRI is promising and indispensable. MRI should be routinely used in conjunction with clinical staging to determine appropriate therapy in patients with cervical carcinoma.
进行了一项前瞻性研究，以比较磁共振成像（MRI）、计算机断层扫描（CT）和麻醉下检查（EUA）在宫颈癌分期中的应用，特别关注宫旁组织状态。对20例宫颈癌患者进行了分析，这些患者的疾病范围经手术证实，分别接受了MRI、CT和EUA检查。MRI估计的肿瘤大小与手术标本组织病理学测量得到的肿瘤大小相关性良好（r = 0.79，p < 0.001）。临床检查和CT均无法精确估计肿瘤大小。MRI对宫颈癌分期的总体准确率为75%，CT分期为32%，临床分期为55%。这些检查方法对宫旁组织状态的准确率分别为：MRI 90%，CT 55%，EUA 82.5%。MRI准确排除了所有20例有盆腔侧壁、膀胱和直肠受累的患者。总之，在评估宫旁组织方面，MRI优于CT和EUA（90%对55%对82.5%，p < 0.005）。通过MRI可以精确估计肿瘤大小。虽然需要进行更大规模的研究来比较MRI和CT以确定它们的作用，但两者都有助于宫颈癌的诊断和合适治疗方案的选择。我们的初步报告与之前的报告一致，即MRI前景广阔且不可或缺。MRI应常规与临床分期联合使用，以确定宫颈癌患者的合适治疗方案。
