T_2WI、DWI及动态增强技术在子宫内膜癌肌层浸润深度判定中的价值

Diagnostic value of T_2WI,DWI,DCE in detecting myometrial invasion of endometrial carcinoma

目的探讨3.0T磁共振成像中T_2WI、DWI及动态增强在子宫内膜癌肌层浸润深度判定中的价值。方法回顾性分析均行3.0T MRI检查且手术病理证实的91例子宫内膜癌患者的资料,将T_2WI、DWI及动态增强对肌层浸润深度的判断结果与手术病理结果进行对照分析。结果 T_2WI序列对子宫内膜癌肌层浸润的判断总符合率为59.3%,DWI判断总符合率为64.8%,动态增强序列总符合率为92.3%,对深肌层浸润诊断的敏感性T_2WI、DWI、动态增强为100%,特异度分别为87.2%、88.4%、97.7%。Kappa一致性检验,动态增强序列与术后病理一致性较好,而常规T_2WI序列、DWI序列一致性较差。结论动态增强扫描,可显著提高对子宫肌层浸润评估的准确性,为临床手术方式的选择提供重要的指导价值。

Objective To evaluate the value of T2WI, DWI, DCE （dynamic contrast-enhanced） in detecting myometrial invasion of endometrial carcinoma.Methods The data of 91 patients with endometrial carcinoma confirmed by surgery and underwent 3.0 T MRI examination were retrospectively analyzed, and the T2WI, DWI and DCE results were compared with pathological results.Results On the myometrial invasion judgment, the total coincidence rate of T2WI, DWI, DCE sequences was 59.3%, 64.8%, 92.3%.On the deep myometrial invasion judgment, the sensitivity of T2WI, DWI, DCE sequence was 100%, the specificity of T2WI, DWI, DCE sequence was 87.2%, 88.4%, 97.7%.The agreement between DCE result and pathological result was good, but the agreement between T2WI, DWI results and pathological result was bad.Conclusion The high accuracy for assessing myometrial invasion achieved makes DCE sequence as an important examination method in selecting the optimal the rapeutic protocol.