论文部分内容阅读
目的探讨磁共振成像(MRI)在子宫内膜癌术前评估中的价值。方法对2004年12月至2007年5月在北京大学临床肿瘤学院初次治疗的43例子宫内膜癌患者术前行MRI检查,并与术后手术病理分期进行对照研究。结果MRI正确评估肿瘤浸润深度35例,错误评估8例,诊断准确率为81.4%。MRI对于肿瘤局限于子宫内膜层、浸润浅肌层及深肌层的诊断敏感性、特异性、准确性分别为100.0%,91.9%和93.0%;76.5%,96.2%和88.4%;80.0%,97.5%和95.3%。对于宫颈受累、侵犯浆膜层及淋巴结转移的诊断敏感性、特异性、准确性分别为:100%,97.5%和95.3%;85.7%,97.2%和95.3%;60%,97.4%和93.0%。MRI区分ⅠA、ⅠB、ⅠC期的准确性为82.1%,鉴别深肌层浸润(ⅠC)和浅表浸润(ⅠA+ⅠB)的准确性为92.9%。结论MRI在判断子宫内膜癌肌层浸润深度及宫颈有无受累方面具有很高价值,是一种较为准确的术前评估方法。
Objective To investigate the value of magnetic resonance imaging (MRI) in the preoperative evaluation of endometrial cancer. Methods 43 patients with endometrial cancer who underwent initial treatment from December 2004 to May 2007 at Peking University School of Oncology were preoperatively examined by MRI and compared with postoperative pathological staging. Results MRI correctly evaluated the depth of tumor invasion in 35 cases, misdiagnosed in 8 cases and diagnostic accuracy of 81.4%. The sensitivity, specificity and accuracy of MRI for the diagnosis of tumors confined to the endometrium, superficial myometrium and deep myometrium were 100.0%, 91.9% and 93.0%, 76.5%, 96.2% and 88.4%, respectively. The accuracy of MRI was 80.0% , 97.5% and 95.3% respectively. The diagnostic sensitivity, specificity and accuracy of cervical involvement, serosal invasion and lymph node metastasis were 100%, 97.5% and 95.3%, 85.7%, 97.2% and 95.3%, 60%, 97.4% and 93.0% . The accuracy of MRI in distinguishing between ⅠA, ⅠB and ⅠC was 82.1%. The accuracy of discriminating deep myometrial invasion (ⅠC) and superficial infiltration (ⅠA + ⅠB) was 92.9%. Conclusion MRI is of high value in determining the depth of myometrial invasion and cervical involvement without endometrial cancer, which is a more accurate preoperative evaluation method.