DWI序列在早期子宫内膜癌肌层浸润的评估价值

Value of diffusion-weighted imaging in myometrial invasion of early endometrial carcinoma

目的探讨磁共振动态增强(DCE)和扩散加权成像(DWI)对早期子宫内膜癌的肌层浸润深度的评估价值。方法选取2014年1月~2016年12月于我院手术病理证实为早期子宫内膜癌的患者68例。所有患者术前均进行了磁共振检查,包括DCE和DWI两种序列。以术后病理结果为准,比较两种检查序列对早期子宫内膜癌的肌层浸润深度的诊断准确率。结果有关肌层浸润方面评估,磁共振DCE序列的整体准确率为75.00%(51/68),DWI序列的整体准确率为91.18%(62/68),DWI序列准确率要高于DCE序列,差异有统计学意义(χ~2=6.332,P<0.05)。DWI浸润Ⅰ级的灵敏度高于DCE序列,差异有统计学意义(χ~2=4.418,P<0.05)。DWI序列判断宫颈浸润的准确率高于DCE序列,差异有统计学意义(χ~2=4.955,P<0.05)。结论在子宫内膜癌肌层浸润深度评估方面,磁共振DWI较DCE序列均有更高的诊断符合率,具有检查时间短、无需对比剂等优点,应作为首选序列。

Objective To compare dynamic contrast-enhanced（DCE） MRI and diffusion-weighted imaging（DWI） in assessing the depth of myometrial invasion in early stage endometrial cancer. Methods 68 patients with stage I-II endometrial cancer underwent DCE-MRI and DWI before surgery. The diagnostic value of the two imaging sequences was compared. Results For detecting muscle invasion, DWI（91.2%, 62/68） was significantly（χ^2=6.332, P〈0.05） more accurate than DCE-MRI（75.0%, 51/68）. The sensitivity of DWI was significantly（χ^2=4.418, P〈0.05） higher than that of DCE-MRI in grade I infiltration. DWI was also significantly（χ^2=4.955, P〈0.05） more accurate than DCE-MRI in assessing cervical infiltration. Conclusion DWI has higher diagnostic accuracy than DCE-MRI for assessing myometrial invasion and overall evaluation of endometrial carcinoma. DWI has the advantages of short imaging time without contrast injection.