Evaluation of MRI-staging and assessment of lymphatic metastasis in cervical cancer / 天津医药

ABSTRACT

Objective To contrast the accuracy rate of nuclear magnetic resonance imaging (MRI)-staging and the International Federation of Gynecology and Obstetrics (FIGO, 2009) clinical-staging, and evaluate the value of MRI in diagnosis of lymph node metastasis in cervical cancer. Methods The surgical pathology was used as golden standard, the accuracy rates of MRI-staging and FIGO-staging were compared in 86 patients of cervical cancer (surgical pathological staging≥Ⅰb). The lymph nodes with slightly hyperintense signal in diffusion-weighted magnetic resonance imaging (DWI) and with minor axis≥1 cm in T2WI-TRA (T2 weighted imaging-transverse section) were considered as metastatic lymph nodes, the characteristics of lymphatic metastasis diagnosed by MRI were analyzed, and the accuracy rate, the sensitivity, the specificity, the positive predictive value and the negative predictive value of MRI were evaluated. Results The accuracy rate of FIGO-staging was 80.2%(69/86), and the accuracy rate of MRI-staging was 83.7%(72/86), there was no significant difference between them (P > 0.05). The accuracy rate of lymphatic metastasis diagnosed by MRI was 94.2%(81/86), the sensitivity was 73.3%(11/15), the specificity was 98.6%(70/71), the positive predictive value was 91.7%(11/12), and the negative predictive value was 94.6%(70/74). The true positive metastatic lymph nodes in 11 cases were located in the external iliac nodes or common iliac lymph nodes, the average short/long diameter was 0.76. The forms of lymph nodes were as followsquasi-circular (n=3), border irregularity (n=3), huge fusion form (n=4), and 1 with central necrosis area. One case of false positive metastatic lymph node was located in the right external iliac node, with the sharp of huge fusion form in T2WI/TRA, comminution in T2WI-axial thin slices, and long strip in T2WI/SAG. Conclusion The accuracy rates of MRI-staging and FIGO-staging were both higher, which can diagnose lymphatic metastasis relatively accurately when they are combined together.