联合应用MR动态增强及T_2WI对Ⅰ、Ⅱ期子宫内膜癌的诊断价值

Value of dynamic contrast-enhanced MR imaging combining with T_2-weighted imaging in the diagnosis of Endometrial Cancer with stage Ⅰ and Ⅱ

目的:评价MR动态增强、T2WI二者结合对Ⅰ、Ⅱ期子宫内膜癌的诊断价值。方法:回顾性分析36例经手术病理证实的子宫内膜癌的T1WI、T2WI和动态增强图像,将MRI判断肌层和宫颈侵犯结果与手术病理比较。结果:MRI动态增强及T2WI二者结合判断子宫内膜癌浸润深度诊断符合率为80.6%,对Ⅰa期的敏感性、特异性,阳性预测值、阴性预测值分别为85.7%、93.1%、75%、96.4%;Ⅰb期的敏感性、特异性,阳性预测值、阴性预测值分别为76.5%、84.2%、81.3%、80%;Ⅰc期的敏感性、特异性,阳性预测值、阴性预测值分别为83.3%、91.7%、83.3%、91.7%;Ⅱ期的敏感度为80%,特异度为96.8%,诊断符合率为94.4%。结论:联合应用MRI动态增强及T2WI判断子宫内膜癌侵犯肌层的深度、范围有很高的临床价值,能够指导临床治疗方式的选择。

Objective：To evaluate the value of MRI Dynamic contrast-enhanced and T2-weighed in stage Ⅰ and Ⅱ Endometrial Cancer.Methods：T1-weighted spin-echo,T2-weighted fast spin-echo and dynamic contrast-enhanced fast multiiplanar spoiled gradient echo sequences before surgery were retrospectively reviewed in 36 cases of endometrial carcinoma proved by operation and pathology.The results of different invasion depth determined by MRI were compared with the findings of postoperative pathology.Results：The accuracy of MRI dynamic contrast enhanced images combining with T2WI were 80% for assessing invasion depth by endometrial carcinoma.The incidence of sensitivity,specficity and positive and negative predictive value was 85.7%,93.1%,75%,96.4% for stage Ⅰa,respectively;76.5%,84.2%,81.3%,80% for stage Ⅰb;respectively;83.3%,91.7%,83.3%,91.7% for stage Ⅰc,respectively.The sensitivity, specificity and accuracy were 80%,96.8% and 94.4% for stage Ⅱ.Conclusion：MRI dynamic contrast enhanced images combining with T2WI is valuable in the assessment of the invasion depth by endometrial carcinoma,which can provide a reasonable choice in therapy strategy.