宫颈癌的分期。体部线圈磁共振成像与直肠内表面线圈磁共振成像的比较及其与组织病理学的相关性。

Staging of cervical carcinomas. Comparison of body-coil magnetic resonance imaging and endorectal surface coil magnetic resonance imaging with histopathologic correlation.

作者信息

Preidler K W, Tamussino K, Szolar D M, Ranner G, Ebner F

机构信息

Department of Radiology, Karl Franzens University, Graz, Austria.

出版信息

Invest Radiol. 1996 Jul;31(7):458-62. doi: 10.1097/00004424-199607000-00009.

DOI:10.1097/00004424-199607000-00009

PMID:8818786

Abstract

RATIONALE AND OBJECTIVES

The authors evaluate the accuracy of magnetic resonance (MR) imaging with body coil and endorectal surface coil techniques in the staging of cervical carcinomas and compare these results with those obtained with clinical staging (International Federation of Gynecology and Obstetrics [FIGO] classification) and postsurgical histopathology.

METHODS

Fifteen patients (average age, 48.6 years) with biopsy-proved cervical cancer were included in the study. After clinical staging (FIGO classification), MR imaging with body coil (BCMR) and subsequently with endorectal surface coil (ECMR) was performed. Using a 1.5-Tesla unit, axial and sagittal proton density weighted and spin echo T2-weighted and fast spin echo T2-weighted sequences were obtained with body and endorectal surface coil. During imaging analysis, special attention was paid to the uterine zones, the vaginal fornix, and the parametrial tissue. Ten patients were treated surgically (postsurgical histopathology was considered the gold standard), five patients, all clinically staged IIIb, underwent primary radiation therapy.

RESULTS

Clinical staging with FIGO classification was accurate in 12 of 15 patients, and understaged in 2 and overstaged in 1 patient. Body coil MR showed accurate staging in 13 of 15 patients. Using this technique, understaging of 2 patients, both with only minimal tumor infiltration depth (< 8 mm), was performed. Endorectal surface coil MR was accurate in 14 of 15 patients missing minimal parametrial tumor infiltration in 1 patient. Histopathology (n = 10) revealed 3 patients with tumor stage T1b, 2 with stage T2a, and 5 patients with stage T2b.

CONCLUSIONS

Although suggested by only a small number of patients, ECMR appears to be the most accurate modality for staging cervical carcinomas but seems to be unreliable in the detection of minimal tumor infiltration.

摘要

原理与目的

作者评估体线圈和直肠内表面线圈技术在宫颈癌分期中的磁共振（MR）成像准确性，并将这些结果与临床分期（国际妇产科联盟[FIGO]分类）及术后组织病理学结果进行比较。

方法

15例经活检证实为宫颈癌的患者（平均年龄48.6岁）纳入本研究。临床分期（FIGO分类）后，先采用体线圈进行MR成像（BCMR），随后采用直肠内表面线圈进行成像（ECMR）。使用1.5特斯拉设备，通过体线圈和直肠内表面线圈获取轴向和矢状位质子密度加权、自旋回波T2加权及快速自旋回波T2加权序列。成像分析过程中，特别关注子宫各区域、阴道穹窿及宫旁组织。10例患者接受手术治疗（术后组织病理学被视为金标准），5例患者（均为临床IIIb期）接受了根治性放疗。

结果

FIGO分类的临床分期在15例患者中有12例准确，2例分期过低，1例分期过高。体线圈MR在15例患者中有13例分期准确。使用该技术，2例患者分期过低，这2例患者肿瘤浸润深度均仅为轻度（<8mm）。直肠内表面线圈MR在15例患者中有14例准确，1例患者漏诊了轻度宫旁肿瘤浸润。组织病理学检查（n = 10）显示3例患者为T1b期肿瘤，2例为T2a期，5例为T2b期。