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目的探讨CT扫描在早期宫颈癌术前诊断中的价值。方法回顾性分析102例宫颈癌的CT扫描,其中包括50例多平面重建(MPR)图像资料,同时与手术病理组织学进行对比研究。全组≤Ⅰa期39例,Ⅰb1期35例,Ⅰb2期21例,Ⅱa期6例,Ⅱb期1例。观察CT对宫颈癌的检出、宫颈受侵深度、肿瘤分期及检出转移淋巴结的作用。结果CT不能检出≤Ⅰa期的宫颈癌,不能显示肿瘤对宫颈侵犯的深度、范围;能够检出≥Ⅰb1期的宫颈癌,检出率为71.4%(45/63例);可显示肿瘤侵犯宫颈的深度,≥Ⅰb1期时正确率为39.7%(25/63例),≥Ⅰb2期时正确率为77.4%(20/28例);对宫颈癌总分期正确率为69.6%(71/102例);对有淋巴结转移的患者,检出率为63.6%(7/11例)。螺旋CT扫描加MPR图像,可增加肿瘤的检出,有利于观察病变及阴道受侵范围。宫颈癌的常见CT表现:病灶呈等密度(56/102例,54.9%),密度低且不均匀(43/102例,42.2%),伴有低密度结节(18/43例,41.9%);病灶也可呈不均匀密度、高密度结节;宫颈表面不规则。转移淋巴结的特征表现:肿大的圆形或椭圆形软组织影,中心密度低或有坏死,边缘呈环状强化。结论CT扫描对≥Ⅰb1期的宫颈癌术前检查有价值,对<Ⅰb期的宫颈癌无价值。螺旋CT扫描加矢状重建,可提高病变的检出率,有利于观察病变的范围。
Objective To investigate the value of CT scanning in the preoperative diagnosis of early cervical cancer. Methods A retrospective analysis of 102 cases of cervical cancer CT scan, including 50 cases of multiplanar reconstruction (MPR) image data at the same time compared with surgical pathology. 39 cases of the whole group ≤ Ⅰa, Ⅰb1 35 cases, Ⅰ b2 21 cases, Ⅱ a 6 cases, Ⅱ b 1 case. To detect the detection of cervical cancer, cervical invasion depth, tumor staging and detection of lymph node metastasis. Results CT can not detect cervical cancer ≤ Ⅰa stage, can not show the depth and extent of tumor invasion of cervical cancer; can detect ≥ Ⅰb1 stage cervical cancer, the detection rate was 71.4% (45/63 cases); can show tumor invasion The correct rate of cervix was 39.7% (25/63 cases) in ≥Ⅰb1 stage, 77.4% (20/28 cases) in stage Ⅰb2 and 69.6% (71/102) in cervical cancer Cases); in patients with lymph node metastasis, the detection rate was 63.6% (7/11 cases). Spiral CT scan plus MPR images can increase the detection of tumors, is conducive to the observation of lesions and vaginal invasion range. Common CT findings of cervical cancer showed that the lesions were isodense (56/102 cases, 54.9%), low density and uneven (43/102 cases, 42.2%), with low density nodules (18/43 cases, 41.9% ); Lesions can also be uneven density, high density nodules; cervical surface irregular. The characteristics of metastatic lymph nodes: swollen round or oval soft tissue shadow, the center of low or necrosis, the edge of the annular enhancement. Conclusion CT scan for ≥ Ⅰb1 of cervical cancer is valuable for preoperative examination of cervical cancer in stage Ⅰb is of no value. Spiral CT scan plus sagittal reconstruction, can improve the detection rate of lesions, is conducive to observe the extent of the lesion.