摘要
目的探讨盆腔小视野矢状位动态增强MRI联合双能扫描CT在Ⅱ期宫颈癌患者宫旁浸润中的诊断价值。方法前瞻性选取2019年1月至2022年11月宿迁市第一人民医院诊断并治疗的96例Ⅱ期宫颈癌患者作为研究对象。所有患者术前均行盆腔小视野矢状位动态增强MRI扫描和双能CT扫描,以术后病理组织诊断结果作为金标准,评价两种影像学方法诊断Ⅱ期宫颈癌患者宫旁浸润的灵敏度、特异度、阳性预测值和阴性预测值。结果(1)术前动态增强MRI扫描诊断Ⅱ期宫颈癌患者宫旁浸润的敏感度、特异度、准确度、阳性预测值、阴性预测值、误诊率、漏诊率分别为89.06%、84.37%、87.50%、91.94%、79.41%、15.63%和10.94%,诊断一致率Kappa值为0.7231。(2)术前双能CT扫描诊断Ⅱ期宫颈癌患者宫旁浸润的敏感度、特异度、准确度、阳性预测值、阴性预测值、误诊率、漏诊率分别为84.38%、81.25%、83.33%、90.00%、72.22%、18.75%和15.63%,诊断一致率Kappa值为0.6364。(3)术前动态增强MRI联合双能CT扫描诊断Ⅱ期宫颈癌患者宫旁浸润的敏感度、特异度、准确度、阳性预测值、阴性预测值、误诊率、漏诊率分别为100.00%、96.88%、98.96%、98.46%、100.00%、3.13%和0,诊断一致率Kappa值为0.9764。ROC曲线结果显示,术前动态增强MRI、双能CT扫描及二者联合诊断宫旁浸润的AUC分别为0.867(95%CI:0.782~0.953)、0.828(95%CI:0.734~0.922)和0.984(95%CI:0.949~1.000)。结论术前盆腔小视野矢状位动态核磁增强和双能扫描CT对Ⅱ期宫颈癌患者宫旁浸润均具有良好的诊断价值,二者联合应用诊断效率更高。
Objective To investigate the diagnostic value of small field sagittal dynamic enhanced MRI combined with dual energy CT in para uterine invasion of stageⅡcervical cancer.Methods A total of 96 patients with stageⅡcervical cancer diagnosed and treated in the First People's Hospital of Suqian from January 2019 to November 2022 as the research objects were prospectively selected.All patients underwent small field sagittal dynamic enhanced MRI scanning and dual energy CT scanning before surgery.The sensitivity,specificity,positive predictive value and negative predictive value of the two imaging methods for diagnosing para uterine invasion in patients with stageⅡcervical cancer were evaluated with the postoperative pathological diagnosis as the gold standard.Results(1)The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,misdiagnosis rate,missed diagnosis rate of preoperative dynamic enhanced MRI scanning in the diagnosis of para uterine invasion in patients with stageⅡcervical cancer were 89.06%,84.37%,87.50%,91.94%,79.41%,15.63%and 10.94%respectively,and the diagnostic consistency rate Kappa value was 0.7231.(2)The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,misdiagnosis rate,missed diagnosis rate of preoperative dual energy CT scanning in the diagnosis of para uterine invasion in patients with stageⅡcervical cancer were 84.38%,81.25%,83.33%,90.00%,72.22%,18.75%and 15.63%respectively,and the diagnostic consistency rate Kappa value was 0.6364.(3)The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,misdiagnosis rate,missed diagnosis rate of preoperative dynamic enhanced MRI combined with dual energy CT scanning in the diagnosis of para uterine invasion in patients with stageⅡcervical cancer were 100.00%,96.88%,98.96%,98.46%,100.00%,3.13%and 0 respectively,and the diagnostic consistency Kappa value was 0.9764.The ROC curve results showed that the AUC of preoperative dynamic enhanced MRI,dual energy CT scanning and their combined diagnosis of parauterine infiltration were 0.867(95%CI:0.782-0.953),0.828(95%CI:0.734-0.922)and 0.984(95%CI:0.949-1.000),respectively.Conclusion Preoperative small field sagittal dynamic MRI and dual energy CT have good diagnostic value for para uterine infiltration in patients with stageⅡcervical cancer,and their combined application is more effective.
作者
刘笑言
马小贝
徐峰
LIU Xiao-yan;MA Xiao-bei;XU Feng(Department of Imaging,The First People's Hospital of Suqian,Suqian Jiangsu 223800,China)
出处
《临床和实验医学杂志》
2023年第10期1111-1114,共4页
Journal of Clinical and Experimental Medicine
基金
江苏省卫健委科研项目(面上)(编号:M2022098)。
关键词
Ⅱ期宫颈癌
宫旁浸润
盆腔动态增强MRI扫描
双能CT
诊断价值
StageⅡcervical cancer
Parauterine infiltration
Dynamic enhanced MRI of pelvic cavity
Dual energy CT
diagnostic value
