Diagnostic Value of Dynamic Enhanced Multi-slice Spiral CT in Lymph Node Metastasis of Cervical Cancer and Analysis of the Causes of Missed Diagnosis
Objective To explore the diagnostic value of multi-slice spiral CT dynamic enhanced scanning(MSCT)in lymph node metastasis of cervical cancer and the causes of missed diagnosis.Methods 283 patients with cervical cancer treated in our hospital from March 2019 to March 2022 were selected as the research object.All patients underwent MSCT to check the lymph node metastasis.The examination results were compared with the surgical and pathological results to analyze the diagnostic value of MSCT.According to the missed diagnosis,the patients with confirmed lymph node metastasis were divided into missed diagnosis group(n=41)and non missed diagnosis group(n=128).The general data and clinicopathological characteristics of the two groups were compared.The factors of missed diagnosis by MSCT were analyzed by multifactor logistic regression,and the back propagation(BP)neural network model was constructed to evaluate the differentiation and accuracy of the model.Results Among 283 patients,169 cases were diagnosed as lymph node metastasis by operation and pathology,128 cases were detected as lymph node metastasis by MSCT and 41 cases were missed.The positive coincidence rate of MSCT diagnosis was 92.75％,the negative coincidence rate was 71.72％,and the total coincidence rate was 81.98％.ROC curve showed that the AUC of MSCT was 0.741(95％CI:0.723～0.826),which had high diagnostic value.High differentiation,Ki-67 negative and interstitial infiltration depth＜1/2 were independent risk factors for missed diagnosis of lymph node metastasis of cervical cancer by MSCT(P＜0.05),and tumor size was independent protective factor(P＜0.05).BP neural network model has good discrimination and high accuracy.Conclusion MSCT has high clinical value in the diagnosis of cervical cancer lymph node metastasis.However,missed diagnosis may occur in patients with tumor size＜4 cm,high differentiation,Ki-67 negative and interstitial infiltration depth＜1/2.Such patients should be diagnosed in combination with other auxiliary examinations.
NETL
NSTL
万方数据
维普
