Value of high-definition magnetic resonance imaging in preoperative evaluation of stage b -Ⅱb cervical cancer / 第二军医大学学报

ABSTRACT

Objective To explore the application value of high-definition magnetic resonance imaging (MRI) in the assessment of preoperative stage B-ⅡB cervical cancer. Methods A retrospective analysis was conducted on 94 patients with cervical cancer who had received preoperative pelvic examination in Changhai Hospital of Navy Medical University (Second Military Medical University) from Mar. 2015 to Jun. 2017. Fifty-eight of them received conventional MRI examination and 36 received high-definition MRI examination. The accuracy, sensitivity and specificity of the three methods for vaginal and parametrial invasion were evaluated using the postoperative pathological assessments as the gold standard. And the Kappa test was used to perform consistency analysis. Results For vaginal invasion, the accuracy, sensitivity and specificity of pelvic examination were 63.8% (60/94), 53.7% (29/54) and 77.5% (31/40), respectively; those of conventional MRI examination were 58.6% (34/58), 48.5% (16/33) and 72.0% (18/25), respectively; and those of high-definition MRI examination were 83.3% (30/36), 76.5% (13/17) and 89.5% (17/19), respectively. Kappa test showed that the consistency of pathology and pelvic examination and high-definition MRI examination assessments was good in evaluating vaginal invasion (Kappa＝0.297, 0.664; P＝0.002, 0.001). For parametrial invasion, the accuracy, sensitivity and specificity of pelvic examination were 79.8% (75/94), 20.0% (1/5) and 83.1% (74/89), respectively; those of conventional MRI examination were 74.1% (43/58), 31.2% (5/16) and 90.5% (38/42), respectively; and those of high-definition MRI examination were 86.1% (31/36), 60.0% (6/10) and 96.1% (25/26), respectively. Kappa test showed that the consistency of pathology and conventional MRI examination and high-definition MRI examination assessments was good in evaluating parametrial invasion (Kappa＝0.251, 0.618; P＝0.040, 0.001). Conclusion High-definition MRI examination and pathological examination have a good consistency in preoperative assessment of cervical cancer at stage B-ⅡB, and can be a common method for preoperative evaluation of cervical cancer.