磁共振多序列成像在子宫内膜癌肌层浸润中的诊断价值

Value of multi-sequence MRI in the diagnosis of myometrial Invasion of endometrial carcinoma.

目的:探讨T2WI、动态增强成像(DCE)、DWI及联合序列(T2WI+DCE+DWI)在Ⅰ期子宫内膜癌肌层浸润中的诊断价值。方法:回顾性分析经手术病理证实为Ⅰ期子宫内膜癌的43例患者的术前MRI资料,分别应用T2WI、DCE、DWI及联合序列对肿瘤肌层浸润深度进行评估,并与病理结果进行对照分析。结果:T2WI、DCE、DWI、联合序列对子宫内膜癌肌层浸润深度的诊断准确率分别为83.72%、88.10%、80.49%、93.02%,4种检查方法的诊断准确率差异无统计学意义(P>0.05)。T2WI、DCE、DWI、联合序列与病理结果的一致性Kappa值分别为0.57、0.66、0.48、0.78。结论:磁共振T2WI、DCE、DWI及联合序列对I期子宫内膜癌肌层浸润深度均具有较高的诊断价值,其中DCE、联合序列与术后病理结果具有高度一致性,T2WI、DCE及DWI序列均是子宫内膜癌术前肌层浸润深度评估的可靠检查方法。

Objective:To investigate the value of T 2WI,dynamic contrast-enhanced imaging(DCE),diffusion weighted imaging(DWI)and multi-sequence of MRI including T 2WI+DCE+DWI in the evaluation of myometrial invasion in stage I endometrial carcinoma.Methods:The MRI materials before surgery of 43 patients with stageⅠendometrial carcinoma proven be pathology were retrospectively analyzed.The depth of myometrial invasion was evaluated by T 2WI,DCE,DWI and the three in combination,the results were correlated with pathology.Results:The accuracy of myometrial invasion identified by T 2WI,DCE,DWI and multi-sequences was 83.72%,88.10%,80.49%and 93.02%,respectively;with no statistical difference(P>0.05).The consistency analyses of T 2WI,DCE,DWI and multi-sequences with pathology evaluated by Kappa value was 0.57,0.66,0.48 and 0.78,respectively.Conclusion:T 2WI,DCE,DWI and multi-sequence of MRI have high diagnostic value in identifying the depth of myometrial invasion of stageⅠendometrial carcinoma,among which,DCE and multi-sequences are highly consistent with postoperative pathological results.T 2WI,DCE and DWI are all reliable assessments in the evaluation of the depth of myometrial invasion in endometrial carcinoma before surgery.