Krestin G P, Hauser M, Eichenberger A, Köchli O R
Departement of Medizinische Radiologie, Universitätsspital Zürich.
Rofo. 1997 Aug;167(2):125-31. doi: 10.1055/s-2007-1015505.
To establish the value of computed tomography (CT) and magnetic resonance imaging (MRI) in predicting bladder and rectum involvement in uterine carcinoma.
6 different imaging signs (focal obliteration of perivesical or perirectal fat planes, area and angle of contact between uterus and bladder or rectum, asymmetric bladder or rectum wall thickening, evidence of intraluminal masses, and signal intensity of bladder or rectum wall on T2-weighted or contrast-enhanced MR images) were analysed retrospectively in 129 patients who underwent 92 CT and/or 64 MRI examinations. The data were correlated with intraoperative findings and the results of cystoscopy and rectoscopy.
Asymmetric wall thickening, evidence of intraluminal masses and increased signal intensities of the bladder wall or rectum wall were valuable signs of infiltration (sensitivity 71-100%, specificity 91-96% and accuracy 89-97%). In 27 patients submitted to both imaging examinations MRI was somewhat superior compared to CT (p > 0.1) and yielded similar results as endoscopic procedures (accuracy of cystoscopy and rectoscopy of 90% and 94%, respectively).
CT and MRI allow to predict involvement of bladder or rectum wall in carcinoma of the uterus with a similar accuracy as endoscopic procedures.
确定计算机断层扫描（CT）和磁共振成像（MRI）在预测子宫癌侵犯膀胱和直肠方面的价值。
回顾性分析129例接受了92次CT和/或64次MRI检查的患者的6种不同影像征象（膀胱周围或直肠周围脂肪平面的局灶性消失、子宫与膀胱或直肠之间的接触面积和角度、膀胱或直肠壁不对称增厚、腔内肿块的证据以及T2加权或对比增强MR图像上膀胱或直肠壁的信号强度）。将这些数据与术中发现以及膀胱镜检查和直肠镜检查结果进行关联。
壁不对称增厚、腔内肿块的证据以及膀胱壁或直肠壁信号强度增加是浸润的有价值征象（敏感性71%-100%，特异性91%-96%，准确性89%-97%）。在接受了两种影像检查的27例患者中，MRI与CT相比略具优势（p>0.1），并且与内镜检查结果相似（膀胱镜检查和直肠镜检查的准确性分别为90%和94%）。
CT和MRI能够以与内镜检查相似的准确性预测子宫癌对膀胱或直肠壁的侵犯。
