Bhosale Priya, Peungjesada Silanath, Devine Catherine, Balachandran Aparna, Iyer Revathy
Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
J Comput Assist Tomogr. 2010 Nov-Dec;34(6):855-64. doi: 10.1097/RCT.0b013e3181ed3090.
Magnetic resonance imaging depicts the morphological details of the female pelvis and is useful for evaluating both benign and malignant cervical masses. Clinical assessment of the extent of cervical cancer is crucial in determining the optimal treatment strategy, but clinical staging by itself has limitations. Clinical staging, as defined by FIGO (International Federation of Gynecologic Oncology), is based on the findings of physical examination, lesion biopsies, chest radiography, cystoscopy, and renal sonography and can be erroneous, depending on the stage of the disease, by 16% to 65%. The prognosis of cervical cancer is determined not only by stage, but also by nodal status, tumor volume, and depth of invasion, none of which are included in the FIGO guidelines. Magnetic resonance imaging has been described as the most accurate, noninvasive imaging modality in staging cervical carcinoma. This review outlines the magnetic resonance features of normal cervix, primary disease (by stage), and recurrent disease and discusses the role of magnetic resonance imaging in staging and clinical decision making.
磁共振成像可描绘女性骨盆的形态细节,有助于评估宫颈的良性和恶性肿块。宫颈癌范围的临床评估对于确定最佳治疗策略至关重要,但单纯的临床分期存在局限性。国际妇产科联盟(FIGO)定义的临床分期基于体格检查、病变活检、胸部X线摄影、膀胱镜检查和肾脏超声检查结果,根据疾病阶段的不同,可能出现16%至65%的误差。宫颈癌的预后不仅取决于分期,还取决于淋巴结状态、肿瘤体积和浸润深度,而这些均未包含在FIGO指南中。磁共振成像被认为是宫颈癌分期中最准确的非侵入性成像方式。本综述概述了正常宫颈、原发性疾病(按分期)和复发性疾病的磁共振特征,并讨论了磁共振成像在分期和临床决策中的作用。