3.0T磁共振在预测子宫内膜癌术后病理分期及病灶部位中的应用

Application of 3.0T MRI in Predicting Postoperative Pathological Stage and Lesion Site of Endometrial Carcinoma

目的探讨术前磁共振检查对术后病理分期及病灶部位预测的准确性。方法选取2015年1月至2019年12月于我院就诊的子宫内膜癌患者172例,所有患者均行常规磁共振扫描和增强磁共振扫描,将术前磁共振检查结果与术后病理结果对比,分析术前磁共振检查对预测术后病理分期及病灶部位的价值。结果 (1)术前磁共振诊断子宫内膜癌Ⅰ期130例,Ⅱ期20例,Ⅲ期17例,IVB期5例,与术后病理结果对比,术前磁共振检查诊断Ⅰ期的敏感性、特异性、阳性预测值和阴性预测值分别为99.2%、97.6%、99.2%、97.6%;Ⅱ期为100.0%、98.1%、85.0%、100.0%;Ⅲ期为76.2%、99.3%、94.1%、96.8%;Ⅳ期为100.0%、99.4%、80.0%、100.0%;(2)磁共振对病灶累及宫颈、局限于宫底+宫角、宫腔的诊断准确率分别为75.0%(18/24)、100.0%(45/45)、89.3%(92/103)。结论术前磁共振检查对预测手术病理分期及病灶部位有较高价值,可为治疗方案的选择提供依据。

Objective To investigate the accuracy of preoperative MRI in predicting postoperative pathological stage and lesion site. Methods A total of 172 patients with endometrial cancer admitted to our hospital from January 2015 to December 2019 were selected. All patients underwent conventional MRI and enhanced MRI scanning. The preoperative MRI results were compared with postoperative pathological results to analyze the value of preoperative MRI in predicting postoperative pathological stage and lesion site. Results(1) The preoperative MRI result was 130 cases of stage I, 20 cases of stage Ⅱ, 17 cases of stage Ⅲ, 5 cases of stage IVB. Compared with postoperative pathological results, the sensitivity, specificity, positive predictive value and negative predictive value of preoperative magnetic resonance examination in diagnosis of Ⅰ stage were 99.2%, 97.6%, 99.2% and 97.6%, respectively;Ⅱ stage for 100.0%, 98.1%, 85.0%, 100.0%;Ⅲ stage for 76.2%, 99.3%, 94.1%, 96.8%;Ⅳ stage for 100.0%, 99.4%, 80.0%, 100.0%;(2) The diagnostic accuracy of MRI for lesions involved in the cervix, confined to the fundus + uterine horn and uterine cavity was 75.0%(18/24), 100%(45/45) and 89.3%(92/103), respectively. Conclusion Preoperative MRI is of great value in predicting surgical pathological stage and lesion site, and provides objective evidence for the selection of treatment.