Sironi S, Zanello A, Rodighiero M G, Vanzulli A, Taccagni G L, Belloni C, Del Maschio A
Cattedra di Ostetricia e Ginecologia, Ospedale S. Raffaele, Milano.
Radiol Med. 1991 May;81(5):671-7.
In the patients with invasive cervical carcinoma, the accurate assessment of parametrial invasion greatly affects the therapeutic choice between surgery and radiation therapy. As a matter of fact, surgery is usually performed only in the patients with carcinoma confined to the cervix, whereas those with parametrial involvement, or more advanced stages, are treated with radiation therapy. This prospective study was aimed at investigating the comparative adequacy of CT and MR imaging in assessing parametrial status in the patients with invasive cervical cancer. Twenty-one consecutive patients, with histologic diagnosis of cervical carcinoma, were investigated. All of them were clinically considered as having invasive cervical cancer (FIGO stages IB-IIB), and subsequently underwent surgery. In all cases, detailed histology of the parametrium was obtained. Pathologic data were compared with CT and MR findings in all cases. As for assessing parametrial involvement by cancer, CT had 62% accuracy, 63% sensitivity, and 60% specificity, versus MR imaging 81% accuracy, 69% sensitivity, and 80% specificity. Therefore, MR imaging appears to be superior to CT in assessing the parametrial status of patients with invasive cervical carcinoma; the method yields valuable information for treatment planning.
在浸润性宫颈癌患者中，对宫旁组织浸润的准确评估极大地影响手术和放射治疗之间的治疗选择。事实上，手术通常仅在癌灶局限于宫颈的患者中进行，而那些有宫旁组织受累或更晚期的患者则接受放射治疗。这项前瞻性研究旨在调查CT和MR成像在评估浸润性宫颈癌患者宫旁组织情况方面的相对充分性。对连续21例经组织学诊断为宫颈癌的患者进行了研究。所有患者临床上均被认为患有浸润性宫颈癌（国际妇产科联盟（FIGO）分期为IB-IIB期），随后接受了手术。所有病例均获取了宫旁组织的详细组织学情况。将所有病例的病理数据与CT和MR检查结果进行了比较。在评估癌灶对宫旁组织的累及情况方面，CT的准确率为62%，敏感性为63%，特异性为60%，而MR成像的准确率为81%，敏感性为69%，特异性为80%。因此，在评估浸润性宫颈癌患者的宫旁组织情况方面，MR成像似乎优于CT；该方法可为治疗方案的制定提供有价值的信息。
