Clinical Study On CT Perfusion And Radiologic Staging Of Cervical Carcinoma

Section onePurpose: To investigate the value of multi-slice CT in staging of cervicalcarcinoma.Methods: 112 cases of cervical carcinomas were evaluated for clinical staging(FIGO staging),and then underwent multi-slice spiral CT examination on which image staging was acquired.Results: Overall accuracy of FIGO staging was 54.46% (61/112). Percentage of underestimation of staging was 22.32% (25/112), and percentage of overestimation of staging18.75% (21/112), 4.46% of the patients were diagnosed by exfoliocytology. Overall accuracy of CT staging was 74.96%(89/112). Percentage of underestimation of staging was 4.46%(5/112), and percentage of overestimation of staging was 11.61%(13/112), 4.46% of the patients were diagnosed by exfoliocytology.Conclusion: CT staging is more accurate than FIGO staging, and is an important staging method before treatment for cervical carcinoma, we suggest that CT should be routinely performed before starting therapy of early cervical carcinoma.Section twoPurpose: To investigate the role of CT in the diagnosis of lymphatic metastasis from cervical carcinoma.Methods: For 108 cases of cervical carcinoma, CT findings of lymphatic metastasis in the location of common, internal, external iliac vessel and paraaortic region were compared with surgical pathologic results.Results: The overall diagnostic sensitivity and specificity of CT was 77.1%, 85.6% respectivlely. For every anatomic location, diagnostic sensitivity and specificity of CT was 87.5%, 55.9% respectively for lymph vessel; 89.8%, 68.8% for common iliac vessel; 64.3%, 92.5% forobturator foramen: 40.0%, 96.9% for paraaortic region. Number of lymph node of positive group was compared with that of negative group with method of t test and significant difference was found between two groups at the location of internal iliac vessel, external iliac vessel, common iliac vessel (P＜0.05).Conclusion: comprehensive analyses of size, number, density of lymph node is very helpful to diagnoses of lymphatic metastasis. Necrosis of lymph node is suggestive of lymphatic metastasis.Section threePurpose: To investigate value of CT perfusion imaging in predicting response of tumor to radiochemotherapy.Methods: 99 cases of cervical carcinoma underwnet CT perfusion scanning, and then radiochemotherapy. They were classified into four groups(CR, PR, SD, PD) according to curative effect. Perfusion parameter (including BF, BY, MTT, PS) among four group were compared.Results: There was significant difference in BV number between CR group and SD, PD group (t=-6.980,7.156; P＜0.05). There was no significant difference in BV number between CR group and PR group (t=2.883; P＞0.05); There was significant difference in PS number between CR group and SD, PD group (t=6.409,5.631; P＜0.05): There was significant difference in PS number between CR group and SD group, PD group (t=7.845,6.982; P＜0.05).Conclusion: There is significant difference in CT perfusion parameter such as BV and PS among four groups and this information is helpful to evaluating response of tumor to radiochemotherapy.