Kainz C, Prayer L, Gitsch G, Stiglbauer R, Kramer J, Reinthaller A, Kölbl H
Second Department of Gynecology and Obstetrics, University of Vienna, School of Medicine, Austria.
J Am Coll Surg. 1994 Mar;178(3):239-44.
Disease status during follow-up evaluation of patients with carcinoma of the ovaries is the main criterion for the selection of appropriate management. A cohort analysis was performed to investigate if magnetic resonance imaging (MRI) could improve noninvasive assessment of disease status in patients with carcinoma of the ovaries during follow-up examination. Twenty-four women with carcinoma of the ovaries after primary surgical treatment with subsequent platinum containing chemotherapy were entered into the study. MRI was performed in addition to sonography and computed tomography (CT). Patients without evidence of disease underwent restaging laparotomy. Sensitivity of sonography, CT and MRI was 50, 63 and 75 percent, respectively. Combination of CT and MRI revealed a 75 percent sensitivity rate. Specificity for sonography, CT and MRI was 100, 94 and 94 percent, respectively, and for the combination of CT and MRI, 88 percent. Positive and negative predictive value and accuracy of these methods were 100, 80 and 83 percent for sonography; 83, 83 and 83 percent for CT; 86, 88 and 88 percent for MRI, and 75, 88 and 83 percent for the combination of CT and MRI. In one instance of false-negative sonographic and CT results, MRI detected recurrence located in postoperative scar tissue. In one instance, MRI did not add essential information to the other imaging methods. Therefore, MRI as a time- and cost-intensive procedure should be reserved for instances in which there are doubtful findings arising with other diagnostic tools, rather than as an indispensable routine procedure in the follow-up evaluation of patients with carcinoma of the ovaries.
卵巢癌患者随访评估期间的疾病状态是选择合适治疗方案的主要标准。进行了一项队列分析，以研究磁共振成像（MRI）能否在随访检查中改善对卵巢癌患者疾病状态的无创评估。24例接受了含铂类药物的初始手术治疗及后续化疗的卵巢癌女性纳入本研究。除超声检查和计算机断层扫描（CT）外，还进行了MRI检查。无疾病证据的患者接受再次分期剖腹手术。超声检查、CT和MRI的敏感性分别为50%、63%和75%。CT和MRI联合检查的敏感性为75%。超声检查、CT和MRI的特异性分别为100%、94%和94%，CT和MRI联合检查的特异性为88%。这些检查方法的阳性和阴性预测值及准确性分别为：超声检查为100%、80%和83%；CT为83%、83%和83%；MRI为86%、88%和88%；CT和MRI联合检查为75%、88%和83%。在1例超声检查和CT结果为假阴性的病例中，MRI检测到位于术后瘢痕组织中的复发。在1例病例中，MRI未为其他成像方法增加关键信息。因此，MRI作为一种耗时且成本高昂的检查，应仅用于其他诊断工具出现可疑结果的情况，而不应作为卵巢癌患者随访评估中不可或缺的常规检查。
