Zhu Yongxiang, Shen Baomei, Pei Xuan, Liu Haixia, Li Guoyan
Department of Gynecology, The Second People's Hospital of Rizhao Rizhao, Shandong Province, China.
Department of Oncology, Binzhou Hospital of Traditional Chinese Medicine Binzhou, Shandong Province, China.
Am J Transl Res. 2021 Sep 15;13(9):10536-10544. eCollection 2021.
OBJECTIVE: To assess the computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) fusion imaging technique features in cervical cancer staging and lymph node metastasis. METHODS: A total of 196 cervical cancer patients undergoing CT, MRI, PET/CT, and PET/MRI preoperatively were enrolled. The diagnostic accuracy and detection rates for paracervical invasion were evaluated on the basis of the International Federation of Gynecology and Obstetrics (FIGO) staging classification for cervical cancer. The diagnostic efficacy of each examination modality for determining lymph node metastasis was evaluated using surgical pathology as a reference. The CT and MRI imaging features of lymph node metastasis were compared. RESULTS: PET/MRI had a higher diagnostic accuracy for cervical cancer (94.90%) than PET/CT, MRI, and CT (83.67%, 75.51%, and 69.39%) ( < 0.05). PET/MRI showed a higher detection rate of vaginal invasion, uterine invasion, bladder invasion, and cervical invasion than PET/CT, MRI, and CT ( < 0.05). The metastasis group showed higher maximum long and short axis diameters and axial ratios than the non-metastasis group ( < 0.05). The metastasis group had higher wash-in rates (WIR), maximum relative enhancements (MRE), wash-out ratios (WOR), and apparent diffusion coefficients (ADC), and lower times to peak (TTP) than the non-metastasis group ( < 0.05). The sensitivity (94.74%), specificity (93.33%), and accuracy (93.88%) of PET/MRI in the diagnosis of cervical cancer lymph node metastasis were higher than the sensitivity, specificity, and accuracy of PET/CT, MRI and CT ( < 0.05). CONCLUSION: CT, MRI, PET/CT and PET/MRI can be used effectively in the diagnosis of cervical cancer staging and lymph node metastasis, among which PET/MRI has a higher diagnostic sensitivity, specificity, and accuracy and is helpful in clinical diagnosis and treatment.
目的:评估计算机断层扫描(CT)、磁共振成像(MRI)和正电子发射断层扫描(PET)融合成像技术在宫颈癌分期及淋巴结转移方面的特征。 方法:纳入196例术前接受CT、MRI、PET/CT和PET/MRI检查的宫颈癌患者。根据国际妇产科联盟(FIGO)宫颈癌分期分类评估宫颈旁浸润的诊断准确性和检出率。以手术病理为参照,评估各检查方式对确定淋巴结转移的诊断效能。比较淋巴结转移的CT和MRI成像特征。 结果:PET/MRI对宫颈癌的诊断准确性(94.90%)高于PET/CT、MRI和CT(分别为83.67%、75.51%和69.39%)(P<0.05)。PET/MRI对阴道浸润、子宫浸润、膀胱浸润和宫颈浸润的检出率高于PET/CT、MRI和CT(P<0.05)。转移组的最大长轴和短轴直径及轴比高于非转移组(P<0.05)。转移组的流入率(WIR)、最大相对强化(MRE)、流出率(WOR)和表观扩散系数(ADC)高于非转移组,而达峰时间(TTP)低于非转移组(P<0.05)。PET/MRI诊断宫颈癌淋巴结转移的敏感性(94.74%)、特异性(93.33%)和准确性(93.88%)高于PET/CT、MRI和CT的敏感性、特异性和准确性(P<0.05)。 结论:CT、MRI、PET/CT和PET/MRI均可有效用于宫颈癌分期及淋巴结转移的诊断,其中PET/MRI具有更高的诊断敏感性、特异性和准确性,有助于临床诊断和治疗。
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