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经直肠超声和磁共振成像在早期宫颈癌分期中的应用

Transrectal ultrasound and magnetic resonance imaging in staging of early cervical cancer.

作者信息

Fischerova D, Cibula D, Stenhova H, Vondrichova H, Calda P, Zikan M, Freitag P, Slama J, Dundr P, Belacek J

机构信息

Department of Obstetrics and Gynecology, Oncogynecological Center, General Teaching Hospital, Charles University, Prague, Czech Republic.

出版信息

Int J Gynecol Cancer. 2008 Jul-Aug;18(4):766-72. doi: 10.1111/j.1525-1438.2007.01072.x. Epub 2007 Sep 24.

Abstract

The goal of this study was to determine the sensitivity, specificity, and accuracy of transrectal ultrasound (TRUS) in comparison to magnetic resonance imaging (MRI) in the evaluation of tumor volume, early parametrial infiltration, and identification of residual tumor in early-stage cervical cancer. Patients in whom an early-stage cervical cancer was diagnosed by clinical examination were enrolled in the study. Only those patients who were examined by both MRI and TRUS with following surgical treatment were included. Imaging results were compared with pathology findings. Altogether, 120 patients were consecutively enrolled from January 2004 to February 2006. Data from 95 patients were evaluated. Correlation coefficient for TRUS- and MRI-derived volumes versus volumes at pathology reached R = 0.996 and R = 0.980, respectively. The accuracy for detecting tumor in 95 patients was 93.7% for TRUS and 83.2% for MRI (P <or= 0.006). In small tumors (<or=1 cm(3)), the accuracy of tumor detection by TRUS was 90.5% and 81.1% by MRI (P <or= 0.049). The accuracy of parametrial infiltration detection by TRUS and MRI was 98.9% and 94.7%, respectively (P <or= 0.219). The accuracy was not influenced by body mass index values. In conclusion, our results showed the accuracy of TRUS as being comparable to the more commonly used MRI in staging of early-stage cervical cancer. TRUS and the pathology-derived volumes correlated tightly; accuracy of TRUS was superior to MRI, especially in detection of residual tumors following conization.

摘要

本研究的目的是确定经直肠超声(TRUS)与磁共振成像(MRI)相比,在评估早期宫颈癌的肿瘤体积、宫旁组织早期浸润及识别残留肿瘤方面的敏感性、特异性和准确性。通过临床检查诊断为早期宫颈癌的患者纳入本研究。仅纳入那些接受了MRI和TRUS检查并随后接受手术治疗的患者。将影像学结果与病理结果进行比较。从2004年1月至2006年2月,共连续纳入120例患者。对95例患者的数据进行了评估。TRUS和MRI得出的体积与病理体积的相关系数分别达到R = 0.996和R = 0.980。95例患者中,TRUS检测肿瘤的准确率为93.7%,MRI为83.2%(P≤0.006)。在小肿瘤(≤1 cm³)中,TRUS检测肿瘤的准确率为90.5%,MRI为81.1%(P≤0.049)。TRUS和MRI检测宫旁组织浸润的准确率分别为98.9%和94.7%(P≤0.219)。准确率不受体重指数值的影响。总之,我们的结果表明,在早期宫颈癌分期方面,TRUS的准确性与更常用的MRI相当。TRUS与病理得出的体积紧密相关;TRUS的准确性优于MRI,尤其是在锥切术后检测残留肿瘤方面。

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