摘要
目的比较PET/CT和PET/MR在诊断宫颈癌原发灶及盆腔淋巴结转移中的应用价值。方法对40例宫颈癌患者于治疗前分别行PET/CT和PET/MR检查并进行评价。采用Kappa一致性检验及配对χ~2检验分别评价PET/CT和PET/MR与金标准的诊断一致性及差异。采用ROC曲线分析两者对盆腔转移淋巴结的诊断效能,采用秩和检验分析两者评价转移淋巴结的可见性及诊断自信度的差异。结果 PET/MR分期与金标准的诊断一致性显著高于PET/CT,二者对宫颈癌分期诊断的差异有统计学意义(χ~2=10.286,P=0.002);PET/CT和PET/MR诊断转移淋巴结的曲线下面积差异无统计学意义(Z=0.83,P>0.05);二者对转移淋巴结的可见性评分差异无统计学意义(P=0.157),诊断自信度评分差异有统计学意义(P=0.014)。结论 PET/CT和PET/MR对检出宫颈癌原发灶均有较高的诊断价值,但PET/MR对宫颈癌分期及判定淋巴结转移有更大的诊断优势,PET/MR有望在综合评价宫颈恶性病变进展中成为替代PET/CT的一种新技术。
Objective To compare the application value between PET/CT and PET/MR in diagnosing primary cervical cancer and pelvic lymph node metastasis. Methods Forty cases of cervical cancer were prospectively enrolled. PET/CT and PET/MR examinations were performed before treatment. All imaging data were evaluated by two experienced radiolo- gists. The diagnostic consistency and difference of PET/CT and PET/MR were evaluated with Coheffs Kappa and paired Chi-square test. ROC curve was adopted to observe the value in diagnosing pelvic lymph node metastasis of cervicaI cancer. The lesions＇ visibility and diagnostic confidence of metastatic lymph nodes on PET/CT and PET/MR images were compared with Wilcoxon signed ranks test. Results Compared with the gold standard, the diagnostic consistency of PET/MR stag- ing was much higher than that of PET/CT （x^2 =10. 286, P=0. 002）. The area under ROC curve of PET/CT and PET/ MR on lymph node metastasis had no significant difference （Z=0.83, P〉0.05）. No significant differences in lesion visi- bility between PET/CT and PET/MR images were detected in the evaluation of metastatic lymph nodes （P=0. 157）, while PET/MR revealed higher values regarding diagnostic confidence （P= 0. 014）. Conclusion Both PET/CT and PET/MR provide high diagnostic value in detecting primary cervical cancer, but PET/MR has greater diagnostic superiority in the correct identification of cervical cancer stage and pelvic lymph node metastasis. PET/MR is expected to be a new technique for replacement of PET/CT in evaluation of cervical lesions.
出处
《中国医学影像技术》
CSCD
北大核心
2018年第1期94-98,共5页
Chinese Journal of Medical Imaging Technology
基金
国家自然科学基金青年科学基金项目(81401438)
关键词
子宫颈肿瘤
淋巴结
肿瘤转移
体层摄影术
发射型计算机
磁共振成像
Uterine cervical neoplasms
Lymph node
Neoplasms metastasis
Tomography, emission-eomputed
Magnetic resonance imaging
作者简介
尚靳（1991-），女，辽宁辽阳人，硕士，医师。研究方向：PET／CT及PET／MR在妇科恶性肿瘤疾病中的诊断价值。E-mail：895495103@qq．com;[通信作者]孙洪赞，中国医科大学附属盛京医院放射科，110004。Email：sunhongzan@126．com
