MRI定性定量参数在子宫癌肉瘤与子宫内膜癌诊断中的价值

目的探讨MRI定性定量参数在子宫癌肉瘤(CS)与子宫内膜癌(EC)诊断和鉴别诊断中的应用价值。方法经临床病理确诊的30例子宫癌肉瘤患者和50例低危型子宫内膜癌患者在手术治疗前均接受MRI检查,包括动态增强扫描(DCE)序列,获得定性定量参数,对其诊断价值进行统计分析。结果子宫癌肉瘤组患者的病灶性质评分和内膜厚度与宫腔前后径之比(ET/AP)均明显高于子宫内膜癌组患者(P<0.05);两组患者的T_(1)W1、T_(2)W1信号强度比较,差异无统计学意义(P>0.05)。子宫肉瘤组患者的ADC以及rADC明显低于子宫内膜癌组患者(P<0.05)。子宫癌肉瘤组患者的DCE扫描参数高于子宫内膜癌组患者(P<0.05)。ET/AP以及DCE扫描参数K^(trans)、K_(ep)、V_(e)对子宫癌肉瘤和子宫内膜癌进行诊断的应用价值较高,AUC值分别为0.721、0.847、0.721、0.941。结论子宫癌肉瘤、子宫内膜癌的MRI定性定量参数中ET/AP和DCE扫描参数的诊断价值较高。

Objective To explore the application value of qualitative and quantitative MRI parameters in the diagnosis and differential diagnosis of uterine carcinosarcoma(CS)and endometrial carcinoma(EC).Methods 30 patients with uterine carcinosarcoma and 50 patients with low-risk endometrial cancer confirmed by clinical pathology received MRI examination,including dynamic enhanced scanning(DCE)sequence,before surgical treatment,to obtain qualitative and quantitative parameters,and statistical analysis of their diagnostic value.Results The lesion property score and ratio of endometrial thickness to anteroposterior diameter of uterine cavity(ET/AP)in the uterine carcinosarcoma group were significantly higher than those in the endometrial cancer group(P<0.05).There was no statistical significance in the relative ratio of T_(1)WI and T_(2)WI signal intensity between two groups(P>0.05).The ADC and rADC of the uterine carcinosarcoma group were significandy lower than those of patients with endometrial cancer group(P<0.05).The DCE scanning parameters,including K^(trans),K_(ep),and V_(e) in the uterine carcinosarcoma group were relatively higher compared with endometrial cancer patients(P<0.05).ET/AP and DCE scan parameters K^(trans),K_(ep) and V_(e) had higher application value in the diagnosis of uterine carcinoma sarcoma and endometrial carcinoma,with AUC values of 0.721,0.847,0.721 and 0.941,respectively.Conclusion ET/AP and DCE scan parameters have higher diagnostic value in qualitative and quantitative MRI parameters of uterine carcinosarcoma and endometrial cancer.