目的：探讨PET/MRI在评价宫颈癌分期及盆腔淋巴结转移中的临床应用价值。方法：前瞻性地将我院收治的70例宫颈癌患者作为研究对象，分别在治疗前行盆腔PET/MRI扫描及全身PET检查。由2名影像科医生对PET/MRI图像进行诊断评价。采用Kappa一致性检验和配对卡方检验分别评价宫颈癌PET/MRI分期和临床分期的诊断一致性和差异性；选用诊断试验指标来分析PET/MRI对宫颈癌盆腔淋巴结转移的诊断价值。统计学软件采用SPSS 22.0。结果：与金标准比较，宫颈癌PET/MRI分期的诊断一致性较好（Kappa=0.908），临床分期的诊断一致性一般（Kappa=0.542），二者对宫颈癌分期的诊断差异具有统计学意义（χ2=9.278，P<0.05）。以患者为基础，PET/MRI诊断盆腔转移淋巴结的准确率、敏感性、特异性分别为92.86％，92.31％，93.18％；以淋巴结为基础，PET/MRI的诊断准确率、敏感性、特异性分别为93.62％，90.32％，94.10％。结论：PET/MRI对宫颈癌分期的诊断价值明显优于临床分期，在评估盆腔淋巴结转移上可准确定性、定位，可作为宫颈癌的一站式检查方法。
Abstract
Objective: To evaluate the clinical value of PET/MRI in staging cervical cancer and diagnosing pelvic lymph node metastasis. Methods: Seventy patients with cervical cancer were prospectively enrolled to perform pelvic PET/MRI and whole-body PET scan before treatment. All the images were evaluated by two experienced radiologists. Kappa consistency test and the paired chi-square test(P<0.05) were separately used to evaluate the consistency and difference of PET/MRI staging and clinical staging. The diagnostic value of PET/MRI for pelvic lymph node metastasis was analyzed by using diagnostic accuracy, sensitivity, specificity. Statistical software SPSS 22.0 was employed for the analysis. Results: Compared with the reference standard, the diagnostic consistency of PET/MRI staging for cervical cancer was satisfactory(Kappa=0.908), the consistency of clinical staging was fair(Kappa=0.542), there was a significant difference between PET/MRI staging and clinical staging(?字2=9.278, P<0.05). In patient-based analysis, the diagnostic accuracy, sensitivity and specificity of PET/MRI for pelvic lymph node metastasis were respectively 92.86％, 92.31％, 93.18％; In lymph node-based analysis, the diagnostic accuracy, sensitivity and specificity of PET/MRI were respectively 93.62％, 90.32％, 94.10％. Conclusion: The diagnostic value of PET/MR for staging of cervical cancer is obviously superior to clinical staging, which can be used as a one-stop inspection method for cervical cancer by accurately determining and positioning pelvic lymph node metastasis.
关键词
宫颈肿瘤 /
淋巴转移 /
磁共振成像 /
正电子发射断层显像术
Key words
Cervix neoplasms /
Lymphatic metastasis /
Magnetic resonance imaging /
Positron-emission tomography
中图分类号：
Ｒ737.33
Ｒ445.2
Ｒ817.4
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