经阴道超声与磁共振诊断子宫内膜癌的价值研究

Value of transvaginal ultrasound and magnetic resonance in the diagnosis of endometrial cancer

目的分析经阴道超声(TVS)和磁共振成像(MRI)在子宫内膜癌术前诊断中的价值。方法回顾性收集并分析2008年10月—2021年6月在华中科技大学同济医学院附属协和医院妇产科就诊,术前已行TVS及MRI检查并术后病理确诊的257例子宫内膜癌患者资料。应用Graphpad Prism 8.3.0统计学软件分析术前TVS和MRI对子宫内膜癌的检出率及一致性。P<0.05为差异有统计学意义。结果病理结果显示ⅠA期患者161例,ⅠB期患者37例,Ⅱ~Ⅲ期59例。术前TVS与MRI对子宫内膜癌总的检出率差异有统计学意义(85.99%vs.94.16%,χ^(2)=9.818,P=0.002)。一致性分析结果显示TVS和MRI诊断子宫内膜癌的Kappa值为0.293,说明TVS和MRI术前诊断子宫内膜癌的一致性较差。TVS和MRI分别与肿瘤分期病理结果的一致性分析显示:TVS与病理结果的Kappa值为0.498,MRI与病理结果的Kappa值为0.867,提示TVS与病理结果有中度一致性,MRI与病理结果有极好一致性,表明MRI与病理结果的一致性优于TVS。结论对术前子宫内膜癌的评估,TVS检查意义有限,MRI检查更为准确。

Objective To analyse the value of transvaginal ultrasound(TVS)and magnetic resonance imaging(MRI)in the preoperative diagnosis of endometrial cancer.Methods We retrospectively collected and analysed a total of 257 patients with endometrial cancer who had undergone TVS and MRI examinations and were pathologically diagnosed after surgery in the Department of Obstetrics and Gynecology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from October 2008 to June 2021.Graphpad Prism 8.3.0 statistical software was used to analyse the preoperative TVS and MRI detection rate and consistency of endometrial cancer.P<0.05 was considered statistically significant.Results The pathological diagnosis results showed 161 cases of endometrial cancer in stage ⅠA,37 cases in stage ⅠB and 59 cases in stages Ⅱ-Ⅲ.The difference in the total detection rate of endometrial cancer between TVS and MRI before surgery was statistically significant(85.99% and 94.16%,χ^(2)=9.818,P=0.002).The results of consistency analysis showed that the Kappa value of TVS and MRI in the diagnosis of endometrial cancer was 0.293,indicating that the consistency of TVS and MRI in the diagnosis of endometrial cancer was poor.The consistency analysis between TVS and MRI and the pathological diagnosis results of tumour staging showed that the Kappa value of TVS and pathological diagnosis results was 0.498,and the Kappa value of MRI and pathological diagnosis results was 0.867.Thus,TVS and pathological diagnosis results have moderate consistency,and MRI and pathological diagnosis results have excellent consistency,indicating that the consistency of MRI and pathological diagnosis results is better than that of TVS.Conclusion For the evaluation of preoperative endometrial cancer,TVS examination is limited,whereas MRI examination is more accurate.