The Value Of MRI In Staging Of Cervical Cancer

Objective：To explore the diagnostic value of MRI, preoperative gynecologicalexamination and intraoperative section specimens in the evaluation of paracervicalinfiltration, vagina involvement and lymph node involvement respectively in thesurgical treatment of patients with cervical cancer.Materials and Methods：50surgical treatment cases were chosen in this studywho were first visit patients as cer-vical cancer from Liaoning Provincial TumorHospital between October1st,2010and January31th,2013. The intact clinicalinformation, MRI imaging data and the intraoperative gross specimen images werecollected, and retrospective analysis was adopted to study the sensitivity, specificity,positive predictive value, negative predictive value, degree of accuracy in theassessment of paracervical infiltration, vagina involvement and lymph nodeinvolvement respectively, which were compared by SPSS (PASW)16.0software,using the postoperative pathology as the golden standard. And surgical-pathologicstaging as gold standard for the accuracy of MRI staging and preoperative clinicalstaging were compared.Results:1. lymph node metastasis:(1) the sensitivity of MRI was67%, specificitywas91%, positive predictive value80%, negative predictive value was83%, degree ofaccuracy was82%.(2) intraoperative observation sensitivity was72%, specificity was94%,positive predictive value87%, negative predictive value was86%, degree ofaccuracy was86%.2.Parametrial infiltration aspects:(1) the sensitivity of MRI was60%, specificity was89%, positive predictive value38%, negative predictive value was95%, degree of accuracy was86%.(2) intraoperative section specimens observationsensitivity of80%, specificity was93%,positive predictive value57%, negativepredictive value was98%, degree of accuracy was92%.(3) the sensitivity of thepreoperative gynecological examination was20%, specificity was100%, positivepredictive value was100%, negative predictive value was92%, degree of accuracy was 92%.3. vagina involvement aspects:(1) the sensitivity of MRI was57%, specificitywas78%, positive predictive value50%, negative predictive value was82%, degree ofaccuracy was72%.(2) intraoperative section specimens observation sensitivity of86%,specificity was100%,positive predictive value100%, negative predictive value was95%,degree of accuracy was96%.(3) the sensitivity of the preoperative gynecologicalexamination was79%, specificity was100%, positive predictive value was100%,negative predictive value was92%, degree of accuracy was94%.Conclusion:1. The result of MRI has a big advantage for cervical cancer lymphnode metastasis.Parametrial invasion have good negative predictive value of95%andspecificity of89%. Vaginal invasion specificity of78%and negative predictive valueof82%are high.2. Gynecological examination parametrial invasion in early stagecervical cancer have a higher specificity of100%and positive predictive value of100%.Vaginal invasion, specificity of100%and positive predictive value of100%are high.3.Intraoperative exploration and intraoperative section specimens observation in thediagnosis of lymph node metastasis, parametrial invasion, vaginal invasion three havegood value.4. MRI in cervical cancer staging overall less accuracy than preoperativeclinical stage. But the difference was not statistically significant.