磁共振成像平扫联合扩散加权成像诊断子宫内膜癌的价值

Value of magnetic resonance imaging without contrast combined with diffusion-weighted imaging in diagnosis of endometrial cancer

目的分析磁共振成像(MRI)平扫联合扩散加权成像(DWI)诊断子宫内膜癌的价值。方法抽取2018年1月至2022年6月漯河市中心医院收治的疑似子宫内膜癌患者81例,均行MRI平扫和DWI诊断。以病理检查结果为金标准,比较MRI平扫、DWI单项和联合的诊断结果及诊断效能,比较不同性质、不同病理分级DWI检查参数[表观弥散系数(ADC)]。结果81例疑似子宫内膜癌患者中,病理检查确诊为恶性63例,良性18例;病理分级G128例,G226例,G39例。MRI平扫诊断为恶性60例,良性21例;DWI诊断为恶性60例,良性21例;MRI平扫与DWI联合诊断为恶性62例,良性19例。MRI平扫与DWI联合诊断子宫内膜癌的灵敏度、特异度、漏诊率、误诊率,与MRI平扫、DWI单项比较差异未见统计学意义(P>0.05),联合诊断准确度高于MRI平扫、DWI单项诊断(Z=8.77,P=0.013)。子宫内膜恶性病灶ADC值低于良性病灶(t=8.09,P<0.05),G3病变ADC值低于G1和G2病变(t=4.46、3.89,P均<0.05)。结论MRI平扫联合DWI诊断子宫内膜癌可提高诊断准确度,且DWI参数和病灶性质、病理分级密切相关,联合诊断能为临床提供多方面信息支持,可提高诊断效果。

Objective To analyze the value of magnetic resonance imaging(MRI)without contrast combined with diffusion-weighted imaging(DWI)in the diagnosis of endometrial cancer.Methods A total of 81 patients with suspected endometrial cancer who were admitted to Luohe Central Hospital from January 2018 to June 2022 were selected,and all of them underwent MRI without contrast and DWI diagnosis.Using pathological examination results as the gold standard,the diagnostic results and diagnostic efficacy of MRI without contrast,DWI,and combination of them were compared.The DWI parameters,that was apparent diffusion coefficient(ADC),of different properties and different pathological grades were compared.Results Among the 81 patients with suspected endometrial cancer,63 cases were malignant and 18 cases were benign diagnosed by pathology;and 28 cases were classified as G1 by pathological examination,26 cases as G2,and 9 cases as G3.The 60 cases were malignant,and 21 cases were benign according to MRI without contrast;60 cases were malignant,and 21 cases were benign according to DWI;62 cases were malignant and 19 cases were benign according to MRI without contrast DWI.There was no significant difference in comparison of sensitivity,specificity,missed diagnosis rate and misdiagnosis rate among combination of MRI without contrast and DWI,single MRI without contrast,and single DWI in the diagnosis of endometrial cancer(P>0.05),and the accuracy of combination of MRI without contrast and DWI was higher than that of single MRI without contrast and single DWI(Z=8.77,P=0.013).The ADC value of malignant endometrial lesions was lower than that of benign lesions(t=8.09,P<0.05),and the ADC value of G3 lesions was lower than those of G1 and G2 lesions(t=4.46,3.89;all P<0.05).Conclusions MRI without contrast combined with DWI in the diagnosis of endometrial cancer can improve the diagnostic accuracy,moreover,DWI parameter is closely related to the nature and pathological grade of the lesions.The combined diagnosis can provide various clinical information support,and can improve the diagnostic effect.