CT和磁共振成像在原发性卵巢癌分期中的应用.doc

CT和磁共振成像在原发性卵巢癌分期中的应用 中华肿瘤杂志 1999年第4期第21卷 临床应用 作者：朱强　吉川裕幸　藤田信行　赵晚苗　清水匡　南部敏和　宫坂和男 单位：100036 北京医科大学临床肿瘤学院影像诊断科(朱强)；日本北海道大学医学院放射科(吉川裕幸、藤田信行、清水匡、南部敏和、宫坂和男)；山西省肿瘤医院放射诊断科(赵晚苗) 　　关键词： 卵巢肿瘤/诊断；体层摄影术，X线计算机；磁共振成像；肿瘤分期 　　【摘要】　目的　探讨CT和磁共振成像（MRI）在原发性卵巢癌分期中的价值和限度。方法　收集42例原发性卵巢癌患者的临床资料，对照手术和病理，获得CT、MRI、CT加MRI各自的准确性、敏感性、特异性（简称三特性）及术前分期。结果　CT和MRI对评价子宫受侵和子宫直肠窝病变均较满意 (三特性均≥80% )。CT在判断单侧或双侧卵巢肿瘤和腹膜种植性病变方面优于MRI，主要是敏感性较高；MRI则在显示包膜受侵或破裂、侵犯除肠管以外的盆腔脏器、子宫直肠窝病变以及淋巴结转移方面优于CT，三特性多数较高。CT、MRI及CT加MRI的分期准确性分别为73.7%、68.4%及70.6%(P＞0.05)。对于多数部位病变的诊断，两者均显示特异性较高而敏感性偏低。结论　CT和MRI是原发性卵巢癌术前分期有效的影像学方法。 Preoperative staging of patients with primary ovarian carcinoma by CT and MRI ZHU Qiang, YOSHIKAWA Hiroyuki, FUJITA Nobuyuki, et al. Department of Radiology, School of Oncology, Beijing Medical University, Beijing 100036 　　【Abstract】　Objective　To investigate values and limitations of CT and MRI applied in staging of patients with primary ovarian carcinoma (POC). Methods　Forty two patients with POC proven by radical surgery, laparotomy, and postoperative pathology were studied. In comparison to surgical and pathological findings, sensitivity, specificity, and accuracy of CT, MRI and CT plus MRI were calculated. Staging by the three imaging methods was obtained according to FIGO′s classification.Results　CT and MRI showed higher accuracy in evaluation of invasion to uterus (89.5% and 94.7%) and disease of Douglas pouch (94.7% and 97.4%). CT was to some extent superior to MRI in assessing ipsilateral or bilateral tumor and lesions related to peritoneal seeding; MRI, however, had better capability of diagnosing invasion to ovarian capsule, pelvic organs excluding bowel, nodules in Douglas pouch, and metastasis to lymph nodes. The overall accuracy of staging by CT, MRI, and CT plus MRI was 73.7%, 68.4%, and 70.6%, respectively (P＞0.05).Conclusion　CT and MRI are useful imaging modalities in staging of POC, but low sensitivity for detecting involvement in some anatomic regions needs to be improved. 　　【Subject words】