三维经阴道超声检查与磁共振成像用于宫颈癌局部分期的一致性研究

Three-Dimensional Transvaginal Sonography and Magnetic Resonance Imaging for Local Staging of Cervical Cancer: An Agreement Study.

作者信息

Arribas Sara, Alcázar Juan Luis, Arraiza Maria, Benito Alberto, Minguez José Angel, Jurado Matias

机构信息

Department of Obstetrics and Gynecology, Hospital Garcia Orcoyen, Estella, Spain.

Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, School of Medicine, Pamplona, Spain

出版信息

J Ultrasound Med. 2016 May;35(5):867-73. doi: 10.7863/ultra.15.05071. Epub 2016 Mar 28.

DOI:10.7863/ultra.15.05071

PMID:27022170

Abstract

OBJECTIVES

To evaluate the agreement of clinical examination, 2-dimensional (2D) sonography, and 3-dimensional (3D) sonography with magnetic resonance imaging (MRI) for local staging of cervical cancer.

METHODS

We conducted a prospective study including women with a diagnosis of carcinoma of the cervix. All women were staged clinically and underwent 2D and 3D transvaginal sonography and MRI before treatment for assessing tumor size and parametrial, bladder, and rectal involvement using the examiner's subjective impression. Agreement between sonography and MRI was assessed by calculating the κ index and percentage of agreement.

RESULTS

Forty women were included (mean age ± SD, 46.6 ± 11.4 years). Eleven had early-stage (IA and IB1) disease, and 29 had advanced-stage (IB2-IVB) disease. A significant correlation for tumor size estimation was found between MRI and pelvic examination (r = 0.754; P < .001), MRI and 2D sonography (r = 0.649; P < .001), and MRI and 3D sonography (r = 0.657; P< .001). Agreement for parametrial infiltration between MRI and pelvic examination was fair (κ = 0.26; 95% confidence interval [CI], 0.10-0.54; 62.5% agreement), between MRI and 2D sonography was moderate (κ = 0.41; 95% CI, 0.15-0.66; 70.0% agreement), and between MRI and 3D sonography was good (κ = 0.60; 95% CI, 0.35-0.85; 80.0% agreement). Agreement for bladder involvement between MRI and pelvic examination was moderate (κ = 0.48; 95% CI, 0.10-0.99; 95.0% agreement), between MRI and 2D sonography was moderate (κ = 0.48; 95% CI, 0.10-0.99; 95.0% agreement), and between MRI and 3D sonography was very good (κ = 0.84; 95% CI, 0.55-1.0; 97.5% agreement). Agreement for rectal involvement was not calculated because of the very small number of cases.

CONCLUSIONS

Three-dimensional sonography showed good agreement with MRI for assessing parametrial infiltration and bladder involvement in cervical cancer.

摘要

目的

评估临床检查、二维（2D）超声检查及三维（3D）超声检查与磁共振成像（MRI）在宫颈癌局部分期中的一致性。

方法

我们进行了一项前瞻性研究，纳入了被诊断为宫颈癌的女性。所有女性均进行了临床分期，并在治疗前接受了二维和三维经阴道超声检查及MRI，以通过检查者的主观印象评估肿瘤大小以及宫旁、膀胱和直肠受累情况。通过计算κ指数和一致性百分比来评估超声检查与MRI之间的一致性。

结果

共纳入40名女性（平均年龄±标准差，46.6±11.4岁）。11名患有早期（IA和IB1期）疾病，29名患有晚期（IB2-IVB期）疾病。在肿瘤大小估计方面，MRI与盆腔检查之间存在显著相关性（r = 0.754；P <.001），MRI与二维超声检查之间存在显著相关性（r = 0.649；P <.001），MRI与三维超声检查之间存在显著相关性（r = 0.657；P<.001）。MRI与盆腔检查在宫旁浸润方面的一致性一般（κ = 0.26；95%置信区间[CI]，0.10 - 0.54；一致性为62.5%），MRI与二维超声检查之间的一致性中等（κ = 0.41；95%CI，0.15 - 0.66；一致性为70.0%），MRI与三维超声检查之间的一致性良好（κ = 0.60；95%CI，0.35 - 0.85；一致性为80.0%）。MRI与盆腔检查在膀胱受累方面的一致性中等（κ = 0.48；95%CI，0.10 - 0.99；一致性为95.0%），MRI与二维超声检查之间的一致性中等（κ = 0.48；95%CI，0.10 - 0.99；一致性为95.0%），MRI与三维超声检查之间的一致性非常好（κ = 0.84；95%CI，0.55 - 1.0；一致性为97.5%）。由于病例数极少，未计算直肠受累的一致性。