MRI、MRI联合DWI及DCE-MRI诊断子宫内膜癌的价值分析

Value analysis of MRI,MRI combined with DWI and DCE-MRI in diagnosis of endometrial carcinoma

目的:探讨常规磁共振成像(Magnetic resonance imaging,MRI)、MRI联合弥散加权成像(Diffusion weighted imaging,DWI)及动态增强成像(Dynamic enhanced imaging,DCE-MRI)检查对子宫内膜癌诊断价值。方法:选择2021年6月至2023年6月于我院检查的74例疑似子宫内膜癌患者作为研究对象。以病理学检查结果作为金标准,分析MRI单项、MRI联合DWI及DCE-MRI检查诊断子宫内膜癌的价值。并计算MRI单项、MRI联合DWI及DCE-MRI诊断子宫内膜癌的结果与病理检查结果的一致性。结果:病理检查结果显示,30例为恶性病变,44例为良性病变。其中29例为子宫内膜不典型增生,10例子宫内膜炎,5例子宫内膜息肉。DCE-MRI诊断子宫内膜癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于MRI、MRI联合DWI(P<0.05)。MRI诊断子宫内膜癌结果与病理检查结果的一致性较差(Kappa=0.371,P<0.05);DWI诊断子宫内膜癌结果与病理检查结果的一致性较理想(Kappa=0.582,P<0.05);MRI联合DWI诊断子宫内膜癌结果病理检查结果的一致性极好(Kappa=0.916,P<0.05)。结论:DCE-MRI检查诊断子宫内膜癌的准确度、灵敏度均高于常规MRI检查与MRI联合DWI检查,与病理检查一致性极好。

Objective:To evaluate the diagnostic value of conventional magnetic resonance imaging(MRI),MRI combined with diffusion-weighted imaging(DWI)and dynamic enhanced imaging(DCE-MRI)in endometrial carcinoma.Methods:74 patients with suspected endometrial cancer examined in our hospital from June 2021 to June 2023 were selected as the study objects.Using the results of pathological examination as the gold standard,the value of single MRI,MRI combined with DWI and DCE-MRI in the diagnosis of endometrial carcinoma was analyzed.The results of single MRI,combined with DWI and DCE-MRI in the diagnosis of endometrial carcinoma were calculated,and the consistency of pathological examination results was calculated.Results:Pathological examination result showed that 30 cases were malignant lesions and 44 cases were benign lesions.There were 29 cases of endometrial dysplasia,10 cases of endometritis,and 5 cases of endometrial polyps.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of DCE-MRI in the diagnosis of endometrial carcinoma were higher than those of MRI,MRI combined with DWI(P<0.05).The results of MRI diagnosis of endometrial carcinoma were not consistent with those of pathological examination(Kappa=0.371,P<0.05).The results of DWI diagnosis of endometrial carcinoma were consistent with those of pathological examination(Kappa=0.582,P<0.05).The pathological results of MRI combined with DWI in the diagnosis of endometrial carcinoma were very consistent(Kappa=0.916,P<0.05).Conclusion:The accuracy and sensitivity of DCE-MRI in the diagnosis of endometrial carcinoma are higher than that of conventional MRI and MRI combined with DWI,and the consistency with pathological examination is excellent.