子宫内膜癌分期与分级选择多模态MRI的诊断意义

Diagnostic significance of multimodal MRI for staging and grading selection of endometrial cancer

目的探究多模态MRI对诊断子宫内膜癌术前分期与分级的临床意义。方法选取2018年1月至2020年1月本院收治的120例子宫内膜癌患者作为研究对象,实施常规平扫、扩散加权成像(DWI)、动态增强磁共振成像(DCE-MRI)及时间-信号曲线(TIC),观察所有患者诊断情况。结果在术后病理分期中Ⅰa期62例(51.67%)、Ⅰb期25例(20.83%)、Ⅱ期17例(14.17%)、Ⅲa期11例(9.17%)、Ⅲb期5例(4.17%)。多模式结合诊断Ⅰa期61例、Ⅰb期24例、Ⅱ期17例、Ⅲa期15例、Ⅲb期3例。3组ADC、rADC值比较差异有统计学意义(P<0.05)。G3的ADC、rADC值均低于G1、G2,G2的ADC、rADC值均低于G1,差异有统计学意义(P<0.05)。两组不同时间点ER值组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:E60~E150 s,两种扫描肌层ER值均高于E30 s,子宫内膜癌肌层前一时间点均高于后一时间点,差异有统计学意义(P<0.05)。E60~E120 s,正常肌层前一时间点均低于后一时间点,差异有统计学意义(P<0.05)。E60、E90 s,正常肌层ER值均低于E150 s,差异有统计学意义(P<0.05);其他时间点两两比较差异无统计学意义。组间比较:E30 s,两种肌层ER值比较差异无统计学意义;E60~E150 s,正常肌层ER值均高于子宫内膜癌肌层,差异有统计学意义(P<0.05)。结论子宫内膜癌实施多模式MRI诊断,可有效观察患者预后分期情况,有利于患者后期治疗,值得临床推广应用。

Objective To explore the clinical significance of multimodal MRI in the preoperative staging and grading of endometrial carcinoma.Methods A total of 120 patients with endometrial cancer admitted to our hospital from January 2018 to January 2020 were selected as research subjects,routine plain scan,diffusion-weighted imaging(DWI),dynamic enhanced(DCE)MRI and time-signal curve(TIC)were performed to observe the diagnosis of all patients.Results There were 62 cases(51.67%)in stageⅠa,25 cases(20.83%)in stageⅠb,17 cases(14.17%)in stageⅡ,11 cases(9.17%)in stageⅢa and 5 cases(4.17%)in stageⅢb.The combination of multiple models diagnosed 61 cases of stageⅠa,24 cases of stageⅠb,17 cases of stageⅡ,15 cases of stageⅢa,and 3 cases of stageⅢb.There were significant differences in ADC and rADC values among the three groups(P<0.05).The ADC and rADC values in G3 were lower than those in G1 and G2,and the ADC and rADC values in G2 were lower than those in G1,the differences were statistically significant(P<0.05).There were significant differences in ER value between the two groups of group,time points and interaction(P<0.05).Comparison within the group:E60-E150 s,ER values of the two scans were higher than those of E30 s,and the pre-time point of endometrial carcinoma was higher than the post-time point,and the differences were statistically significant(P<0.05).E60-E120 s,the pre-time point of normal muscle layer was lower than the post-time point,and the difference was statistically significant(P<0.05).E60,E90 s,ER value of normal muscle layer were lower than E150 s,the difference was statistically significant(P<0.05).there were no differences in pairwise comparison at other time points.Comparsion between groups:E30 s,there was no significant difference in ER value between the two muscle layers;for E60-E150 s,ER values of normal muscle layer were higher than those in endometrial carcinoma muscle layer,and the differences were statistically significant(P<0.05).Conclusion Multi-modal MRI diagnosis of endometrial cancer can effectively observe the prognosis and stage of patients,which is conducive to the later treatment of patients,and is worthy of clinical promotion and application.