Application Of MRI In The Diagnosis And Staging Of Cervical Cancer Before Operation

Background and PurposeCervical cancer is the most common female reproductive tract malignant tumors, which is the third in the world just behind breast cancer, rectum and colon cancer morbidity statistics.In developing countries, it only fellow behind breast cancer. At present, there are many methods to check for cervical cancer, soft tissue pathology biopsy is the most common way, however it can not reveal the range of cervical cancer invasion, and mostly with invasive. With the improvement of imaging technology and soft tissue resolution of MRI (Magnetic Resonance Imaging, MRI), which can be quick to make accurate judgment with tumors. Especially MRI is beneficial to the degree of tumor invasion and the scope of the tumors.This can also use in the cervix, which can clear show the differences signals of womb, also brings good administrative levels between various organizations and the tumor tissue. MRI can clearly show the location of the tumor lesion as well as the size and the scope of the invasion with multi-parameter imaging.MRI have a high sensitivity and specificity. In the clinical diagnosis of cervical cancer MRI has advantages of diagnostic value, which can provide help for the clinical treatment of cervical cancer. This experiment was to study magnetic resonance imaging for cervical cancer diagnosis and preoperative staging of application value.Materials and MethodsThe 60 cervical cancer patients which was selected from June 2013 to June 2014 in our hospital. There are 49 cases of squamous cell carcinoma, small cell carcinoma (3 cases),3 cases of glands squamous carcinoma,2 cases of clear cell adenocarcinoma,2 cases of adenocarcinoma,1 case of poorly differentiated cervical neuroendocrine carcinoma in. This was diagnosised by cervical biopsy before the preoperative. All of the 60 patients Age 27-76, the average (56.5+13.3) years old, the median age of 55.In the 25 patients with stage ⅠB～ⅡA period operate with total hysterectomy and extensive total hysterectomy and pelvic lymph node cleaning operation,35 patients with stage ⅡB with locality open surgery or lymph node biopsy. Ostoperative pathological examination results as the gold standard in the diagnosis of cervical cancer.All of the 60 cases were performed with 750 GE 3.0 T MRI machine scanning, which have 8 channel body dedicated phased front. All patients underwent routine pelvic MRI scan sequence T1WI, T2WI, DWI (b=800 s/was), and LAVA-Flex dynamic enhanced scan which performed after Gd-DTPA by intravenous.The data and statistical analysised by using SPSS19.0.The dates from the MRI preoperative staging, preoperative clinical staging and the postoperative pathologic staging, were compared through chi-square test, also compared the rates of preoperative MRI in cervical cancer deep muscularis infiltration, vagina involvement, beside the palace and infiltration and lymph node metastasis diagnosis with postoperative pathologic results count rates. The difference was statistically significant (P<0.05).Sensitivity:the ability to correct diagnosis of a disease, Se=a/a +c; Specificity:the right to rule out the ability of a certain disease, Sp=d/b+d.Results1. The differences have the statistical significance (P<0.05), that 60 cases of cervical cancer patients perforned with preoperative MRI staging and preoperative clinical staging and the postoperative pathologic staging. There have no statistical significance(P>0.05) between preoperative MRI staging and the postoperative pathologic staging. It exited difference between preoperative MRI staging and preoperative clinical points (P<0.05).As well as the postoperative pathological staging and cervical cancer preoperative MRI staging accuracy was 93.3%, the overall preoperative clinical staging accuracy is only 74.9%.2. It has higher sensitivity and specificity between preoperative MRI diagnosis and postoperative pathologic result in cervical cancer deep muscularis infiltration, vagina involvement, beside the palace and infiltration and lymph node metastasis, each respectively 85.7%,98.1%,95.7%,97.4%,95%,90.1%,81.8%,96.1%. The difference between the two is not statistically significant (P> 0.05) though chi-square test. So there have consistency between preoperative MRI and postoperative pathological results in clinical.Conclusion1. MRI examination of cervical cancer has a high accuracy for preoperative staging.2. MRI has high clinical coincidence rate, sensitivity and specificity in cervical cancer deep muscularis infiltration, vagina involvement, beside the palace and infiltration and lymph node metastasis.3. MRI has more reliable objective basis in making cervical cancer staging, therefore, MRI can be used to assess cervical cancer preoperative accurate staging, this can help select and formulate reasonable cervical cancer treatment plan.