磁共振成像、弥散加权成像及动态增强成像诊断子宫内膜癌的临床研究

Clinical Research of Magnetic Resonance Imaging,Diffusion-weighted Imaging and Dynamic Contrast-enhanced Imaging in the Diagnosis of Endometrial Cancer

目的探讨弥散加权成像(DWI)和动态增强成像(DCE-MRI)及磁共振成像(MRI)诊断子宫内膜癌的价值。方法分析80例疑似子宫内膜癌病人的MRI和DWI及DCE-MRI影像的资料,以手术后病理诊断结果为标准,分析MRI、DWI及DCE-MRI诊断子宫内膜癌的价值,ROC分析定量参数Ktrans值、Kep值、Ve值、ADC对子宫内膜的诊断效能。结果经病理确诊,80例患者子宫内膜癌61例,良性子宫内膜疾病19例。MRI、DWI、DCE-MRI正确诊断子宫内膜癌灵敏度分别为5 7.38%、63.93%、80.33%;特异度分别为78.95%、82.41%、84.21%。子宫内膜癌患者ADC值低于良性患者(P<0.05),Ktrans、Kep、Ve值高于良性患者(P<0.05)。Ktrans、ADC诊断子宫内膜癌AUC较高,分别为0.922 (95%CI:0.864~0.992,P=0.000)、0.872(95%CI:0.767~0.977,P=0.000)。结论 DWI、DCE-MRI诊断子宫内膜癌具有较高价值,其参数Ktrans、ADC可作为子宫内膜癌早期诊断的定量指标。

Objective To evaluate the value of magnetic resonance imaging(MRI),diffusion-weighted imaging(DWI),and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) in the diagnosis of endometrial cancer.Methods The imaging data of 80 patients with suspected endometrial cancer were retrospectively analyzed.The diagnostic value of MRI,DWI and DCE-MRI in endometrial cancer was analyzed.The diagnostic efficacy of quantitative pa ra meters Ktrans,Kep,Ve,and ADC in endometrial cancer was analyzed by ROC.Results Eighty-six patients with endometrial ca ncer and 19 patients with benign endometrial disease were diagnosed by pathology.The sensitivity of M RI,DWI,and DCE-M RI in the correct diagnosis of endometrial ca rcinoma were 57.38%,63.93%,and 80.33%,and the specificity were 78.95%,82.41%,and 84.21%,respectively.The ADC value of patients with endometrial cancer was lower than that of benign patients(P<0.05),and the values of Ktrans,Kep,and Ve were higher than those of benign patients(P<0.05).The AUC of Ktrans and ADC were 0.922(95% CI:0.864-0.992,P=0.000) and 0.872(95% CI:0.767-0.977,P=0.000).Conclusion DWI and DCE-MR have high value in the diagnosis of endometrial cancer.The parameters Ktrans and ADC can be used as quantitative indicators for ea rly diagnosis of endomet rial cancer.