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目的探讨MRI动态增强扫描在子宫内膜癌手术前诊断中的价值。方法回顾分析2008年2月2010年3月38例经手术病理证实为子宫内膜癌患者的动态增强MRI检查资料,判断内膜癌子宫肌层和宫颈浸润情况,与病理结果对照,计算T2WI及动态增强序列诊断肌层及宫颈浸润的敏感度、特异度、准确度等,分析两种序列诊断准确度有无差异;计算内膜癌组织与子宫肌层在动态增强各期的对比信噪比,并分析其在各期间有无差异。结果动态增强序列诊断内膜癌肌层和宫颈受侵的敏感度、特异度、阳性预测值、阴性预测值分别为96.8%、85.7%、96.8%、85.7%和85.7%、91.7%、85.7%、91.7%;动态增强序列诊断内膜癌深肌层浸润的准确度为94.7%,显著高于T2WI诊断深肌层浸润的准确度78.9%(P<0.05);平衡期内膜癌组织与子宫肌层的对比信噪比显著高于动脉期和静脉期(P<0.01)。结论 MRI动态增强扫描能够在手术前准确的判断内膜癌肌层及宫颈浸润,有助于子宫内膜癌治疗方式的选择。
Objective To investigate the value of dynamic contrast-enhanced MRI in the preoperative diagnosis of endometrial cancer. Methods A retrospective analysis of 38 cases of endometrial carcinoma confirmed by surgery and pathology in February 2008 and March 2010 was performed on dynamic contrast-enhanced MRI to determine the myometrial and cervical infiltration in endometrial carcinoma. Comparing with the pathological findings, T2WI and Dynamic enhanced sequence of diagnosis of muscular and cervical infiltration sensitivity, specificity, accuracy, analysis of the accuracy of the two sequences of the diagnosis of any difference; calculation of endometrial cancer and myometrial dynamic enhanced in each phase of the signal to noise ratio , And analyze whether there is any difference between the periods. Results The sensitivity, specificity, positive predictive value and negative predictive value of dynamic enhanced sequences for the diagnosis of endometrial carcinoma and cervical invasion were 96.8%, 85.7%, 96.8%, 85.7% and 85.7%, 91.7% and 85.7% , 91.7% respectively. The accuracy of dynamic enhanced sequence in diagnosing endometrial carcinoma was 94.7%, which was significantly higher than that of T2WI in diagnosing deep myometrial invasion (78.9%, P <0.05) The signal to noise ratio of muscular layer was significantly higher than that of arterial phase and venous phase (P <0.01). Conclusion MRI dynamic contrast-enhanced MRI can accurately determine the invasion of endometrial carcinoma and cervical before surgery, which is helpful for the choice of treatment of endometrial cancer.