CO2注入法在Ⅰ期子宫内膜癌术前磁共振成像分期诊断中的应用

Application of CO2 injection method in the magnetic resonance imaging preoperative staging diagnosis for stage Ⅰ carcinoma of endometrium

目的 探讨CO2注入法及常规磁共振成像（MRI）对Ⅰ期子宫内膜癌术前分期诊断的准确性.方法 采用将CO2气体经导管注入子宫腔内的方法对38例Ⅰ期子宫内膜癌患者进行盆腔MRI扫描,对Ⅰ期子宫内膜癌进行术前分期诊断.以病理分期结果为金标准,对CO2注入法与常规扫描方法（43例）的诊断符合率进行比较.结果 常规扫描组Ⅰ期子宫内膜癌分期诊断符合率为81.3 ％（35/43）,其中ⅠA期为75.0 ％（6/8）,ⅠB期为83.9 ％（26/31）,ⅠC期为75.0 ％（3/4）;子宫腔内注入CO2组分期诊断符合率为89.4 ％（34/38）,其中ⅠA期为85.7％（6/7）,ⅠB期为88.9％（16/18）,ⅠC期为84.6％（12/13）.两组分期诊断符合率差异有统计学意义（x2=7.81,P＜ 0.05）.结论 采用CO2注入法能够更准确地判断子宫内膜癌的发生部位和肌层浸润程度,该方法简便、安全,有一定的推广价值.

Objective To explore the accuracy rate of CO2 injection method and conventional magnetic resonance imaging （MRI） in the staging diagnosis for stage Ⅰ carcinoma of endometrium.Methods Preoperative staging diagnosis for stage Ⅰ carcinoma of endometrium was done,and the method of injecting CO2 gas into the uterine lumen by catheter was applied for pelvic MRI scan in 38 cases of stage Ⅰ carcinoma of endometrium.The pathological staging result was treated as the gold standard to compare the accuracy rate of CO2 injection method with conventional scan method （43 cases）.Results For conventional MRI scan group,the accuracy rate of staging diagnosis in stage Ⅰ carcinoma of endometrium was 81.3 % （35/43）,including stage Ⅰ A 75.0 %（6/8）,stage Ⅰ B 83.9 %（26/31）,stage Ⅰ c 75.0 %（3/4）.For CO2 injection group,the accuracy rate was 89.4 %（34/38）,including stage Ⅰ A 85.7 %（6/7）,stage Ⅰ B 88.9 %（16/18）,stage Ⅰ c 84.6 % （12/13）.There was a statistical difference between the accuracy rates of two methods （x2=7.81,P 〈 0.05）.Conclusion Compared with conventional scan method,the CO2 injection method with better simplicity,safety and application value,could be more accurate to determine the location of endometrial cancer and the degree of myometrial infiltration.