, , ,

(Medical Imaging Center, Nanfang Hospital of Southern MedicalUniversity, Guangzhou 510515, China)

Comparison of contrast enhanced MR angiography and CT angiography in displaying blood supply of early stage cervical cancer

LEILizhi,XUYikai*,HOUMeirong,HEMengqi

(MedicalImagingCenter,NanfangHospitalofSouthernMedicalUniversity,Guangzhou510515,China)

Objective To compare the display effect of contrast enhanced MR angiography (CE-MRA) and CTA in evaluating blood supply of early stage cervical cancer. Methods CE-MRA and CTA before the operation of 30 patients with pathologically confirmed early stage cervical cancer were analyzed retrospectively. The origins and continuity of bilateral uterine arteries and the conspicuity of bilateral decending branch of uterine arteries between CE-MRA and CTA were evaluated. Results Fifty uterine arteries could classify as origins clearly visible and vessels clearly visible without discontinuity, 5 uterine arteries as origins clearly visible but vessels unclearly visible on both CE-MRA and CTA. Both CE-MRA and CTA were conformed well in evaluating the origin and continuity of uterine arteries (Kappa=0.80,P<0.05). The conspicuity of decending branches for CE-MRA was 55.00% (33/60), which was lower than that of CTA (73.33% [44/60]), which had statistically significant difference between CE-MRA and CTA (χ2=26.22,P<0.01). Conclusion For early stage cervical cancer, CE-MRA and CTA can both provide a good performance in evaluating the origin and continuity of uterine arteries, CTA reveals advantage over CE-MRA in detecting conspicuity of decending branch of uterine arteries.

Uterine cervical neoplasms; Uterine artery; Tomography, X-ray computed; Magnetic resonance imaging; Angiography

早期宫颈癌的首选治疗方法是手术，尽管经典的广泛全子宫加盆腔淋巴结清扫术疗效明显，但手术范围广，术后并发症多发，对患者术后的生活质量均有不同程度的影响[1]。近年来，随着腹腔镜下根治切除术及动脉导管内化疗栓塞等微创技术的应用，使患者可在不影响临床预后的前提下，达到减少术中出血量、缩短住院时间、保留生育及卵巢功能的目的[2]。术前明确早期宫颈癌患者供血血管的情况，可提高手术的可控性。采用CTA和增强磁共振血管成像(contrast enhanced MR angiography， CE-MRA)等血管成像技术在术前显示子宫动脉越来越受到临床重视。本研究回顾性评价CE-MRA和CTA对早期宫颈癌供血血管的显示效果。

1 资料与方法

1.1 一般资料 收集2014年10月—2016年7月我院收治的30例早期宫颈癌患者(ⅠB及ⅡA期)，病理诊断均为宫颈鳞状细胞癌，年龄27～65岁，平均 (47.1±8.1)岁。纳入标准：①均接受CTA和CE-MRA检查，且检查间隔时间不超过2周；②在接受上述血管造影检查前未进行任何针对宫颈癌的抗肿瘤治疗；③无其他盆腔内疾病；④子宫动脉主干及子宫动脉下行支不存在血管数目上的形态学变异。所有患者均签署知情同意书。

1.2仪器与方法

1.2.1CT检查 采用Siemens Somatom Definition 64排双源螺旋CT机，检查前禁食4～6 h。患者取仰卧位，头足方向扫描，扫描范围自第3腰椎下缘至耻骨联合下缘。管电压120 kV，管电流320 mA，层厚5 mm，层间距5 mm。常规平扫后，采用双筒高压注射器，经右肘正中静脉注射优维显(370 mgI/ml) 80 ml，流率4.0 ml/s(A筒)，再以相同流率(B筒)追注生理盐水20 ml。选择腹主动脉分叉上3.0 cm为ROI行CT值动态监测，当CT值达100 HU时自动触发扫描(动脉期)。……