3．0TMRI对Ⅰ期子宫内膜癌术前分期的诊断价值

Diagnostic value of 3. 0 Tesla MRI for preoperative staging of stage Ⅰendometrial carcinoma

目的:探讨3.0T MRI对Ⅰ期子宫内膜癌术前分期的诊断价值。方法:回顾性分析经病理证实的53例Ⅰ期子宫内膜癌患者的临床资料。患者术前均行MRI平扫(T1WI、T2WI、DWI)、动态增强扫描以及经阴道彩色多普勒超声(TVCDS)检查。结果:53例患者术后病理分期为Ⅰa期(无肌层浸润)15例、Ⅰb期(浅肌层浸润)22例、Ⅰc期(深肌层浸润)16例。联合MRI动态增强扫描、T2WI及DWI的术前分期为Ⅰa期16例、Ⅰb期22例、Ⅰc期15例,与术后病理分期符合率为88.68%(Kappa=0.828,P<0.001)。TVCDS术前分期为Ⅰa期18例、Ⅰb期21例、Ⅰc期14例,与术后病理分期符合率为66.03%(Kappa=0.485,P<0.001)。MRI多序列联合术前分期与术后病理分期符合率显著高于TVCDS(χ2=7.756,P=0.005)。结论:联合应用3.0T MRI动态增强扫描、T2WI及DWI是一种术前进行Ⅰ期子宫内膜癌分期较理想的检查方法。

Aim：To evaluate the diagnostic value of 3.0 Tesla MRI for preoperative staging of stageⅠendometrial car-cinoma.Methods：A total of 53 cases of stageⅠendometrial carcinoma confirmed by pathology were retrospectively ana-lyzed.All cases were performed unenhanced scanning （ T1 WI, T2 WI, DWI ） , dynamic contrast-enhanced imaging and transvaginal color dopple sonography （ TVCDS） .Results：The postoperative pathological results showed that 15 cases wereⅠa （ no myometrial involvement ） , 22 cases were Ⅰb（ superficial myometrial invasion ） and 16 cases were Ⅰc（ deep myo-metrial invasion ） .The preoperation staging result of combined application of MR dynamic contrast -enhanced imaging , T2 WI and DWI was 15 cases of Ⅰa, 22 cases of Ⅰb and 16 cases of Ⅰc.The diagnostic coincidence rate with pathologi-cal staging was 88.68%（Kappa=0.828,P〈0.001）.The preoperation staging result of TVCDS was 18 cases of Ⅰa, 21 cases of Ⅰb and 14 cases of Ⅰc.The diagnostic coincidence rate with pathological staging was 66.03%（Kappa=0.485, P〈0.001）.The diagnostic coincidence rate of MRI was significantly higher than that of TVCDS （χ^2 =7.756, P=0.005）. Conclusion：Combined application of MR dynamic contrast-enhanced imaging , T2 WI and DWI is an ideal method for the preoperative staging of stageⅠendometrial carcinoma .