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目的：探讨宫颈癌的MRI 表现与分期，评价其诊断价值及临床意义。方法：由2 名经验丰富的妇科肿瘤医师前瞻性地对80 例宫颈活组织病理检查证实为宫颈癌或可疑早期浸润癌的患者进行妇科盆腔检查，共同决定分期和手术可行性。对可直接手术或经先期治疗后有手术可能的患者，于开始治疗前2 周内（平均6.5d)行盆腔和腹膜后MRI 扫描。在MRI 图像上观察原发肿瘤的位置、信号特征及侵犯范围。将MRI 分期与临床分期进行对比，手术病理分期为金标准，采用诊断检验方法，以敏感度、特异度、准确度3 项指标分析MRI 判断宫颈癌分期、宫旁侵犯和盆腔淋巴结转移的价值。结果：MRI 对宫颈癌术前分期的总准确度为 88.7%，对浸润性癌（Ⅱa 及Ⅱa 以上）诊断准确度为86.7%。MRI 对宫旁侵犯的判断敏感度为85.2% ,特异度为85% , 准确性为 85.1 %，MRI 预测淋巴结转移的敏感度为58% ，特异度为96% ,准确性为90%。结论：MRI 能多方位清晰显示宫颈癌瘤灶及侵犯范围与途径，明显优于其他影像学检查方法，MRI 对术前宫颈癌分期明显优于临床，可做为宫颈癌术前常规的影像检查方法。

英文摘要:

Objective: To analyze the MRI manifest and staging of cervical cancer, and evaluate its role in clinical diagnosis. Methods: Two experienced gynecologists applied pelvioscopy to the 80 cases ,who were diagnosed as cervical cancer or doubtful early-stage infiltrating cervical cancer by pathology. And the gynecologists decided how to stage the patients' cancer and how to operate together. Two weeks (6.5 d averagely) before the treatment ,MRI scanning were applied to patients' cavitas pelvis and aft -peritoneum. Then observe the location, signal feature and infiltrating scope in MRI slices. Compare MRI staging with clinical diagnosis, with pathology results as gold standard. The evaluating index concludes sensitivity, specificity and accuracy. Results: The total accuracy of MRI staging in cervical cancer diagnosis before surgery is 88.7%, and the accuracy of infiltrating cancer (Ⅱa and Ⅱa above) diagnosis is 86.7%. The MRI sensitivity and specificity in uterus-side infiltration diagnosis are 85.2% and 85% respectively. And the sensitivity, specificity and accuracy in lymph-node metastasis are 58% , 96% and 90% respectively. Conclusion: MRI has a superiority over other iconography examinations, and it also has higher efficacy over clinical gynecological examination in cervical cancer diagnosis before surgery. Therefore, MRI should be applied as regular examination before cervical cancer surgery.

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