磁共振在术前诊断子宫内膜癌肌层浸润及宫颈侵犯中的意义

Significance of magnetic resonance imaging in the preoperative diagnosis of myometrial invasion and cervical invasion of endometrial carcinoma

目的：探讨磁共振在术前诊断子宫内膜癌肌层浸润及宫颈侵犯中的意义。方法选择本院2011年4月~2014年4月收治的子宫内膜癌患者38例，均经术后病理组织学检查证实，所选患者均行磁共振检查，分析磁共振诊断对子宫内膜癌肌层浸润和宫颈侵犯诊断的灵敏度、特异度、阳性预测值及阴性预测值。结果磁共振对肌层浸润诊断的准确率为86.8%，漏诊率为25.0%，误诊率为10.0%。磁共振检查、预测深肌层浸润的灵敏度为75.0%，特异度为90.0%，阳性预测值为66.7%，阴性预测值为93.1%。磁共振诊断宫颈侵犯准确率为65.8%，漏诊率为66.7%，误诊率为26.5%。磁共振诊断宫颈侵犯的灵敏度为33.3%，特异度为71.9%，阳性预测值为18.1%，阴性预测值为85.1%。结论磁共振在术前诊断子宫内膜癌的肌层浸润及宫颈侵犯有助于术式选择，具有重要临床检查意义。

Objective To explore the significance of magnetic resonance imaging （MRI） in the preoperative diagnosis of myometrial invasion and cervical invasion of endometrial carcinoma. Methods 38 patients with endometrial cancer treated in our hospital from April 2011 to April 2014 were selected,and they were confirmed by postoperative histopathologic examination.The selected patients were given MRI examination.The sensitivity,specificity,positive pre-dictive value and negative predictive value of MRI diagnosis for myometrial invasion and cervical invasion of endome-trial carcinoma was analyzed respectively. Results The accurate rate of diagnosis of myometrial invasion using MRI was 86.8%,the rate of missed diagnosis was 25.0%,the rate of misdiagnosis was 10.0%.The sensitivity of deep myometrial invasion by the diagnosis of MRI was 75.0%,the specificity was 90.0%,the positive predictive value was 66.7%,the neg-ative predictive value was 93.1%.The accurate rate of diagnosis of cervical invasion by MRI was 65.8%,the rate of missed diagnosis was 66.7%,the rate of misdiagnosis was 26.5%.The sensitivity of cervical invasion by the diagnosis of MRI was 33.3%,the specificity was 71.9%,the positive predictive value was18.1%,the negative predictive value was 85.1%. Conclusion MRI in the preoperative diagnosis of myometrial invasion and cervical invasion for endometrial car-cinom is helpful to the selection of operating methods,and has important clinical examination significance.