AbstractThe position of the internal os of the cervix reported in the literature was inconsistent on MRI images. Additionally, the practical impactful data influencing the internal os located by MRI is limited. We aimed to confirm the position of the internal os of the cervix on MRI images, and the influencing factors locating the the internal os by MRI.

摘要文献报道的宫颈内部os的位置在MRI图像上不一致。此外，影响MRI定位的内部操作系统的实际影响数据是有限的。我们旨在通过MRI图像确认宫颈内部os的位置，以及通过MRI定位内部os的影响因素。

A single-center retrospective study was conducted. Data from 175 patients who underwent total hysterectomy for stage I endometrial cancer were collected. The internal os of the cervix is positioned as the starting point for measuring the length of the cervix on MRI images. On dynamic contrast-enhanced MRI (DCE-MRI), the section formed by the enhancement difference between the uterus and cervix, and on T2-weighted imaging(T2WI), the section formed by the physiological curvature of the uterus and the low signal intensity of the cervical stroma were used as starting points.

进行了单中心回顾性研究。收集了175例因I期子宫内膜癌接受全子宫切除术的患者的数据。宫颈的内部os被定位为在MRI图像上测量宫颈长度的起点。在动态对比增强MRI（DCE-MRI）上，由子宫和宫颈之间的增强差异形成的切片，以及在T2加权成像（T2WI）上，由子宫的生理曲率和宫颈间质的低信号强度形成的切片被用作起点。

The results showed no statistically significant difference compared with the removed uterus specimens (p = 0.208, p = 0.571, p = 0.804). A history of cesarean section(p < 0.001), irregular vaginal bleeding for more than three months(p < 0.001), cervical adenomyosis(p = 0.043), and premenopause(p = 0.001) were not conducive to locating the internal os of the cervix by MRI.

结果显示，与切除的子宫标本相比，差异无统计学意义（p=0.208，p=0.571，p=0.804）。剖宫产史（p<0.001），不规则阴道出血超过三个月（p<0.001），宫颈腺肌病（p=0.043）和绝经前（p=0.001）不利于通过MRI定位宫颈内部os。

Our findings provide valuable information and confirm the position of the internal os of the cervix on MRI images, and the several important infuencing factors. We hope that some patients will benefit from our study..

我们的发现提供了有价值的信息，并证实了宫颈内部os在MRI图像上的位置，以及几个重要的影响因素。我们希望一些患者将从我们的研究中受益。。

IntroductionFertility preservation is an essential component of clinical treatment plans and a critical determinant of patient quality of life after treatment1. For patients with cervical cancer (CC) and patients with endometrial cancer (EC) desiring fertility preservation, accurate locating of the cervical internal os through imaging evaluation is required to determine the distance of the tumor from the cervical internal os.

引言保留生育能力是临床治疗计划的重要组成部分，也是治疗后患者生活质量的关键决定因素1。对于希望保留生育能力的宫颈癌（CC）和子宫内膜癌（EC）患者，需要通过影像学评估准确定位宫颈内部os，以确定肿瘤与宫颈内部os的距离。

For women with CC who wish to have children, MRI needs to indicate the pattern of tumor growth and three-dimensional size (whether it is < 2.0 cm) and the distance from the tumor to the internal cervical os (< 1.0 cm)2,3. For patients with EC, locating the internal cervical os is critical to distinguishing the involvement of the lower uterine segment or cervix4,5.According to the literature, two methods exist for locating the internal cervical os on MRI images6,7,8,9,10.

对于希望有孩子的CC女性，MRI需要显示肿瘤生长模式和三维大小（无论是2.0厘米还是2.0厘米）以及从肿瘤到内部宫颈os的距离（<1.0厘米）2,3。对于EC患者，定位内部宫颈os对于区分子宫下段或宫颈4,5的受累至关重要。根据文献，在MRI图像上定位内部宫颈os有两种方法6,7,8,9,10。

Firstly, the literature pointed out that the internal cervical os is located at the entry point of the uterine blood vessels on MRI images6,7. However the location was marked inconsistent. Secondly, the internal cervical os is located at the transition from the low signal intensity of the cervical stroma on T2WI images to the position of medium signal intensity of the uterine myometrium7,9,10.

首先，文献指出，在MRI图像上，内部宫颈os位于子宫血管的入口点6,7。但是，位置标记不一致。其次，内部宫颈os位于从T2WI图像上宫颈间质的低信号强度到子宫肌层的中等信号强度位置的过渡7,9,10。

However, in actual clinical practice, when some patients have chronic inflammation of the cervix, nabothian cysts, or distorted boundaries between the uterus and cervix, it becomes difficult to determine the boundary between the cervical stroma and the uterine body. In such cases, other methods must be explored to locate the internal os of the cervix.Therefore, we retrospectively analyzed the data of stage I patients with EC who came to the hospital for surgery, recorded the cervical length o.

然而，在实际的临床实践中，当一些患者患有宫颈慢性炎症，nabothian囊肿或子宫和宫颈之间的边界扭曲时，很难确定宫颈基质和子宫体之间的边界。在这种情况下，必须探索其他方法来定位宫颈的内部os。因此，我们回顾性分析了来医院接受手术的I期EC患者的数据，记录了宫颈长度o。

Data availability

数据可用性

Reaearch datd will be shared upon reasonable request to the corresponding author.

研究数据将在合理的要求下分享给通讯作者。

ReferencesFloyd, J. L. et al. Fertility preservation in women with early-stage gynecologic cancer: Optimizing oncologic and reproductive outcomes. Int. J. Gynecol. Cancer. 31, 345–351 (2021).Article

参考文献Floyd，J.L.等人，《早期妇科癌症患者的生育能力保存：优化肿瘤和生殖结局》。国际妇科杂志。癌症。31345-351（2021）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Salib, M. Y. et al. 2018 FIGO staging classification for cervical cancer: Added benefits of imaging. Radiographics 40, 1807–1822 (2020).Article

Salib，M.Y.等人2018年宫颈癌FIGO分期分类：成像的额外益处。。文章

PubMed

PubMed

Google Scholar

谷歌学者

Schuurman, T. et al. Fertility-sparing surgery in gynecologic cancer: A systematic review. Cancers (Basel) 13, 1008 (2021).Article

Schuurman，T.等人，《妇科癌症中保留生育能力的手术：系统综述》。癌症（巴塞尔）131008（2021）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Garzon, S. et al. Fertility-sparing management for endometrial cancer: Review of the literature. Minerva Med. 112, 55–69 (2021).Article

Garzon，S.等。子宫内膜癌的保留生育能力管理：文献综述。密涅瓦医学杂志112,55-69（2021）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Nougaret, S. et al. Endometrial cancer MRI staging: Updated guidelines of the european society of urogenital radiology. Eur. Radiol. 29, 792–805 (2019).Article

Nougaret，S.等人，《子宫内膜癌MRI分期：欧洲泌尿生殖放射学会最新指南》。欧洲放射性。29792-805（2019）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Lakhman, Y. et al. Stage IB1 cervical cancer: Role of preoperative MR imaging in selection of patients for fertility-sparing radical trachelectomy. Radiology 269, 149–158 (2013).Article

Lakhman，Y。等。IB1期宫颈癌：术前MR成像在选择保留生育能力的根治性宫颈切除术患者中的作用。放射学269149-158（2013）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Bipat, S. et al. The role of magnetic resonance imaging in determining the proximal extension of early stage cervical cancer to the internal os. Eur. J. Radiol. 78, 60–64 (2011).Article

Bipat，S.等人。磁共振成像在确定早期宫颈癌向内部os近端延伸中的作用。欧洲放射杂志。。文章

ADS

广告

PubMed

PubMed

Google Scholar

谷歌学者

Hricak, H. et al. Invasive cervical carcinoma: Comparison of MR imaging and surgical findings. Radiology 166, 623–631 (1988).Article

Hricak，H。等。浸润性宫颈癌：MR成像和手术结果的比较。放射学166623-631（1988）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Sahdev, A. et al. The performance of magnetic resonance imaging in early cervical carcinoma: A long-term experience. Int. J. Gynecol. Cancer 17, 629–636 (2007).Article

Sahdev，A。等人。磁共振成像在早期宫颈癌中的表现：长期经验。国际妇科杂志。癌症17629-636（2007）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Peppercorn, P. D. et al. Role of MR imaging in the selection of patients with early cervical carcinoma for fertility-preserving surgery: Initial experience. Radiology 212, 395–399 (1999).Article

Peppercorn，P.D.等人。MR成像在选择早期宫颈癌患者进行保留生育能力手术中的作用：初步经验。放射学212395-399（1999）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Pecorelli, S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int. J. Gynaecol. Obstet. 105, 103–104 (2009).Article

Pecorelli，S。修订了外阴癌，宫颈癌和子宫内膜癌的FIGO分期。国际妇科杂志。障碍。105103-104（2009）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Wendell-Smith, C. P. The lower uterine segment. J. Obstet. Gynaecol. Br. Emp. 61, 87–93 (1954).Article

Wendell Smith，C.P。子宫下段。J、 障碍。妇科。商业管理人员。61，87-93（1954）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Chaemsaithong, P. et al. Uterine artery pulsatility index in the first trimester: Assessment of intersonographer and intersampling site measurement differences. J. Matern. Fetal Neonatal. Med. 31, 2276–2283 (2018).Article

Chaemsaithong，P.等人，《妊娠早期子宫动脉搏动指数：超声检查者间和采样部位间测量差异的评估》。J、 马特。胎儿新生儿。医学312276-2283（2018）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Pilarczyk, K. Variability of the course of the uterine artery and its branches within the broad ligament and vascularization of uterine walls depending on a woman’s age in light of anatomical, radiologic and microangiographic studies. Ann. Acad. Med. Stetin. 41, 43–55 (1995).CAS

Pilarczyk，K。根据解剖学，放射学和微血管造影研究，子宫动脉及其分支在阔韧带内的变化和子宫壁的血管形成取决于女性的年龄。安。阿卡德。Stetin医生。41,43-55（1995）。中科院

PubMed

PubMed

Google Scholar

谷歌学者

Conrad, JT. Ueland, K. Physical characteristics of the cervix. Clin Obstet Gynecol. 26,27-36 (1983).Hoffmann, J. et al. Cesarean section scar in 3 T magnetic resonance imaging and ultrasound: Image characteristics and comparison of the methods. Arch. Gynecol. Obstet. 299, 439–449 (2019).Article .

康拉德，JT。Ueland，K。宫颈的物理特征。临床妇产科。26,27-36（1983）。Hoffmann，J.等。3 T磁共振成像和超声波中的剖宫产瘢痕：图像特征和方法比较。拱门。妇科。障碍。299439-449（2019）。文章。

PubMed

PubMed

Google Scholar

谷歌学者

Marotta, M. L. et al. Laparoscopic repair of post-cesarean section uterine scar defects diagnosed in nonpregnant women. J. Minim. Invasive Gynecol. 20, 386–391 (2013).Article

Marotta，M.L.等。腹腔镜修复非妊娠妇女剖宫产术后子宫瘢痕缺损。J、 最小值。侵入性妇科。20386-391（2013）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Gala, F. B. et al. Magnetic resonance imaging of uterine cervix: A pictorial essay. Indian J. Radiol. Imaging 31, 454–467 (2021).Article

Gala，F.B.等。子宫颈磁共振成像：一篇图片文章。印度J.Radio。成像31454-467（2021）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Atalay Mert, S. et al. A rare case of the cervical endometriosis and overview of the literature. Reprod. Sci. 30, 2882–2886 (2023).Article

Atalay-Mert，S。等。一例罕见的宫颈子宫内膜异位症及文献综述。重新编程。科学。302882-2886（2023）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Munro, M. G. et al. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int. J. Gynaecol. Obstet. 143, 393–408 (2018).Article

Munro，M.G.等人，《生殖年份正常和异常子宫出血症状的两个FIGO系统以及异常子宫出血原因的分类：2018年修订版》。国际妇科杂志。障碍。143393-408（2018）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Dyne, P. L. & Miller, T. A. The patient with non-pregnancy-associated vaginal bleeding. Emerg. Med. Clin. North Am. 37, 153–164 (2019).Article

Dyne，P.L。＆Miller，T.A。患有非妊娠相关性阴道出血的患者。急诊医学临床。North Am.37153-164（2019）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Nelson, H. D. Menopause. Lancet 371, 760–770 (2008).Article

Nelson，H.D。更年期。柳叶刀371760-770（2008）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Sosnovski, V. et al. Complex nabothian cysts: A diagnostic dilemma. Arch. Gynecol. Obstet. 279, 759–761 (2009).Article

Sosnovski，V。等人，《复杂的纳博提亚囊肿：诊断困境》。拱门。妇科。障碍。279759-761（2009）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Berek, J. S. et al. Endometrial cancer staging subcommittee, FIGO women’s cancer committee. FIGO staging of endometrial cancer: 2023. Int. J. Gynaecol. Obstet. 162, 383–394 (2023).Article

Berek，J.S.等人，FIGO妇女癌症委员会子宫内膜癌分期小组委员会。子宫内膜癌的FIGO分期：2023年。国际妇科杂志。障碍。162383-394（2023）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Wang, C. B. et al. Cesarean scar defect: Correlation between cesarean section number, defect size, clinical symptoms and uterine position. Ultrasound Obstet. Gynecol. 34, 85–89 (2009).Article

Wang，C.B.等。剖宫产瘢痕缺损：剖宫产数量、缺损大小、临床症状与子宫位置的相关性。超声波障碍。妇科。34,85-89（2009）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Nizić, D. et al. Flexion and version of the uterus on pelvic ultrasound examination. Acta Med. Croatica. 68, 311–315 (2014).PubMed

Nizić，D.等人。骨盆超声检查中子宫的屈曲和扭转。克罗地亚医学学报。68311-315（2014）。PubMed出版社

Google Scholar

谷歌学者

Download referencesAcknowledgementsThe authors thank AiMi Academic Services (www.aimieditor.com) for English language editing and review services. The authors also thank the Institute of Clinical Medicine of the Beijing Friendship Hospital for its guidance on statistical methods.Author informationAuthors and AffiliationsDepartment of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, ChinaMingming Liu & Yuting LiangBeijing Maternal and Child Health Care Hospital, Beijing, ChinaMingming Liu, Yuting Liang, Xingzheng Zheng & Na MoDepartment of Radiology, Beijing Friendship Hospital, Capital Medical University, No.59 Yong’an Road, Xicheng District, Beijing, ChinaMingming Liu & Erhu JinDepartment of Pathology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, ChinaXingzheng Zheng & Na MoAuthorsMingming LiuView author publicationsYou can also search for this author in.

下载参考文献致谢作者感谢AiMi Academic Services（www.aimieditor.com）提供的英语编辑和评论服务。作者还感谢北京友谊医院临床医学研究所对统计方法的指导。作者信息作者和附属机构首都医科大学北京妇产科医院放射科，北京，中国刘明明和梁玉亭北京妇幼保健院，北京，中国刘明明，梁玉亭，郑兴政和Na北京友谊医院放射科，首都医科大学，北京市西城区永安路59号刘明明和二胡金北京妇产科医院病理科，首都医科大学，北京，中国郑兴政和Na作者刘明明观点作者出版物您也可以在中搜索这位作者。

PubMed Google ScholarYuting LiangView author publicationsYou can also search for this author in

PubMed Google ScholarYuting LiangView作者出版物您也可以在

PubMed Google ScholarXingzheng ZhengView author publicationsYou can also search for this author in

PubMed谷歌学者郑兴政查看作者出版物您也可以在

PubMed Google ScholarNa MoView author publicationsYou can also search for this author in

PubMed Google ScholarNa MoView作者出版物您也可以在

PubMed Google ScholarErhu JinView author publicationsYou can also search for this author in

PubMed Google ScholareHu JinView作者出版物您也可以在

PubMed Google ScholarContributionsMingmingLiu, Yuting Liang, Xingzheng Zheng and No Ma were in charge of data acquisition, analysis and interpretation. MingmingLiu was responsible for manuscript drafting and made a contribution to study conception and design. Erhu Jin critically reviewed and revised the manuscript and supervised the study.

PubMed谷歌学术贡献刘明明、梁玉婷、郑兴正和无马负责数据采集、分析和解释。刘明明负责手稿的起草，并为研究概念和设计做出了贡献。金二胡批判性地审查和修改了手稿，并监督了这项研究。

All authors read and approved the final manuscript.Corresponding authorCorrespondence to.

所有作者都阅读并批准了最终稿件。对应作者对应。

Erhu Jin.Ethics declarations

二胡锦。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

作者声明没有利益冲突。

Additional informationPublisher's noteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Rights and permissions

Additional informationPublisher的noteSpringer Nature在已发布地图和机构隶属关系中的管辖权主张方面保持中立。权限和权限

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material.

开放获取本文是根据知识共享署名非商业性NoDerivatives 4.0国际许可证授权的，该许可证允许以任何媒介或格式进行任何非商业性使用，共享，分发和复制，只要您对原始作者和来源给予适当的信任，提供知识共享许可证的链接，并指出您是否修改了许可材料。

You do not have permission under this licence to share adapted material derived from this article or parts of it..

根据本许可证，您无权共享源自本文或其部分的改编材料。。

The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder..

本文中的图像或其他第三方材料包含在文章的知识共享许可中，除非在材料的信用额度中另有说明。如果材料未包含在文章的知识共享许可中，并且您的预期用途不受法律法规的许可或超出了许可的用途，则您需要直接获得版权所有者的许可。。

To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

要查看此许可证的副本，请访问http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissionsAbout this articleCite this articleLiu, M., Liang, Y., Zheng, X. et al. Study on the value of MRI in locating the internal OS of the cervix and influencing factors.

转载和许可本文引用本文Liu，M.，Liang，Y.，Zheng，X。等人研究MRI在定位宫颈内部OS中的价值及其影响因素。

Sci Rep 14, 17784 (2024). https://doi.org/10.1038/s41598-024-68735-7Download citationReceived: 10 December 2023Accepted: 26 July 2024Published: 01 August 2024DOI: https://doi.org/10.1038/s41598-024-68735-7Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Sci Rep 1417784（2024）。https://doi.org/10.1038/s41598-024-68735-7Download引文接收日期：2023年12月10日接收日期：2024年7月26日发布日期：2024年8月1日OI：https://doi.org/10.1038/s41598-024-68735-7Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

Provided by the Springer Nature SharedIt content-sharing initiative

由Springer Nature SharedIt内容共享计划提供

KeywordsFertility preservationSurgeryInternal Os of cervixLocalizationMagnetic resonance imaging

关键词保留生育能力手术宫颈定位的内部Os磁共振成像

CommentsBy submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

。如果您发现有虐待行为或不符合我们的条款或准则，请将其标记为不合适。