磁共振扩散加权成像技术诊断子宫内膜癌价值分析

Diagnostic Value of Magnetic Resonance Diffusion Weighted Imaging Technique in Endometrial Cancer

目的:探讨磁共振扩散加权成像技术诊断子宫内膜癌价值。方法:选取笔者所在医院2014年1月-2018年6月58例经术后病理证实为子宫内膜癌患者,均给予磁共振平扫+动态增强+磁共振扩散加权成像技术(DWI)检查,分析影像学检查与病理检查判定EC分期的准确性、不同病理类型及分化程度间ADC值的差异。结果:术后病理证实,58例患者中Ⅰa期24例,Ⅰb期12例,Ⅱ期16例,Ⅲ期6例;平扫+增强判定Ⅰa期准确性为75.00%(18/24),Ⅰb期准确性为58.33%(7/12),Ⅱ期准确性为81.25%(13/16),Ⅲ期准确性为100%(6/6),总准确性为75.86%(44/58);平扫+增强+DWI判定Ⅰa期准确性为91.67%(22/24),Ⅰb期准确性为83.33%(10/12),Ⅱ期准确性为93.75%(15/16),Ⅲ期准确性为100%(6/6),总准确性为91.37(53/58)。平扫+增强+DWI判定EC分期准确性显著高于平扫+增强,差异有统计学意义(x^2=5.098,P=0.024)。内膜样腺癌患者ADC值显著高于非内膜样腺癌患者,高、中分化患者ADC值显著高于低分化患者,差异均有统计学意义(P<0.05)。结论:磁共振扩散加权成像技术是一种方便、快捷的成像方式,在对女性盆腔检查时信号比较高,能够弥补常规平扫+增强成像的不足,尤其对子宫内膜癌的病灶能够清晰显示,同时测量ADC值有利于鉴别子宫内膜癌病理类型和分化程度,为临床手术和治疗提供依据。

Objective:To investigate the value of magnetic resonance diffusion weighted imaging in the diagnosis of endometrial cancer.Method:From January2014 to June 2018,58 patients with endometrial cancer confirmed by postoperative pathology were treated with magnetic resonance plain scan+dynamic enhancement+magnetic resonance diffusion weighted imaging(DWI).The accuracy of EC staging was detected by imaging examination and pathological examination,and differences of ADC values among different pathological types and differentiation degrees were analysed.Result:Postoperative pathology confirmed 24 cases of stageⅠa,12 cases of stageⅠb,16 cases of stageⅡ,and 6 cases of stageⅢin 58 patients.Plain scan+enhancement showed that the accuracy of stageⅠa was 75.00%(18/24)and the accuracy of stageⅠb was 58.33%(7/12),the accuracy of stageⅡwas 81.25%(13/16),the accuracy of stageⅢwas 100%(6/6),the total accuracy was 75.86%(44/58).Plain scan+enhancement+DWI showed that the accuracy of stageⅠa was 91.67%(22/24),the accuracy of stageⅠb was 83.33%(10/12),the accuracy of stageⅡwas 93.75%(15/16),and the accuracy of stageⅢwas 100%(6/6),the total accuracy was 91.37(53/58).Plain scan+enhancement+DWI to determined the accuracy of EC staging was significantly higher than that of the plain scan+enhancement,and the difference was statistically significant(x^2=5.098,P=0.024).The ADC value of endometrial adenocarcinoma was significantly higher than that of non-endometrial adenocarcinoma.ADC values in patients with high and medium differentiation were significantly higher than those in patients with low differentiation,and the differences were statistically significant(P<0.05).Conclusion:Magnetic resonance diffusion weighted imaging technology is a kind of convenient and fast imaging method.When the pelvic examination is performed on women,the signal is higher,which makes up for the deficiency of conventional plain scan+enhancement imaging.Especially the lesions of endometrial cancer can be cleared.Simultaneously,it showed that measurement of ADC values facilitate discriminating endometrial cancer pathological types and differentiation degrees,and it can provide the basis for clinical surgery and treatment.