Background:The most prevalent type of gynecological cancer is endometrial cancer.Accurate surgical staging is the most important aspect in the management of endometrial cancer.Preoperative evaluation of myometrial inv...Background:The most prevalent type of gynecological cancer is endometrial cancer.Accurate surgical staging is the most important aspect in the management of endometrial cancer.Preoperative evaluation of myometrial invasion and appropriate management could be achieved by transvaginal sonography and pelvic MRI.Methods:A total of 53 patients with endometrial cancer,who were referred to a gynecology oncology department of an academic hospital in Mashhad University of Medical Sciences from 2018 to 2020,were evaluated in this study.Data were collected using a questionnaire on endometrial cancer.All the patients underwent preoperative transvaginal sonography and pelvic MRI to evaluate myometrial invasion.The involvement of myometrium thickness and histological findings were compared between two imaging modalities,and SPSS 23.0 was used to analyze the data.Results:Junctional irregularity was the most prevalent finding on transvaginal sonography.Based on transvaginal sonography,myometrial invasion of less than 50%was found in 73%of patients,while invasion of more than 50%was observed in 26.31%.In 57.44%of MRIs,there was less than 50%myometrial invasion,while in 42.55%of MRIs,there was more than 50%myometrial invasion.In both modalities,the most common finding was myometrial invasion of less than 50%.The accuracy,sensitivity,and specificity of transvaginal sonography were 0.47,0.27,and 0.75,respectively,whereas the accuracy,sensitivity,and specificity of MRI were 0.54,0.45,and 0.61,respectively.Conclusion:MRI can be the modality of choice for evaluating myometrial invasion and optimizing endometrial cancer treatment planning,as well as reducing the complications of non-indicated lymphadenectomy.展开更多
目的:探讨超声与核磁共振(MRI)在鉴别女性盆腔肿物中的诊断价值。方法:选取2020年1月-2022年12月于宜昌市中心人民医院行手术治疗的65例女性盆腔肿物患者,收集所有患者的临床资料,内容包括术前超声及MRI检查结果、术后病理资料等。结果...目的:探讨超声与核磁共振(MRI)在鉴别女性盆腔肿物中的诊断价值。方法:选取2020年1月-2022年12月于宜昌市中心人民医院行手术治疗的65例女性盆腔肿物患者,收集所有患者的临床资料,内容包括术前超声及MRI检查结果、术后病理资料等。结果:在盆腔肿物的定位诊断中,MRI检查的准确率高于超声(95.38%vs 83.08%,P<0.05),其中腹膜内肿物MRI定位符合率97.92%,超声定位符合率为93.75%;腹膜后肿物MRI定位符合率88.24%,超声定位符合率为52.94%。在盆腔肿物诊断良恶性方面,MRI检查的灵敏度(98.00%vs 92.00%)、特异度(86.67%vs 66.67%)和符合率(95.38%vs 86.15%)均优于超声检查组。良性病变最常见的病理类型为子宫肌瘤、卵巢囊肿及输卵管积液/积脓,恶性病变最常见的病理类型为腹膜后淋巴肿瘤、卵巢恶性肿瘤。本研究发现腹膜内与腹膜后肿物平均直径差异有统计学意义(4.5±1.7 cm vs 7.9±3.4 cm)(P<0.05)。结论:MRI在女性盆腔肿物定位及良恶性鉴别诊断方面均优于超声。展开更多
盆腔器官脱垂(pelvic organ prolapse,POP)是指由于盆底支持结构薄弱导致的盆腔器官疝出.动态MRI为无放射性、无创、快捷、全面、高分辨率的检查方法,其软组织对比性强,可清晰显示静息位及动态位时盆底肌肉和筋膜组织结构及功能上的变化...盆腔器官脱垂(pelvic organ prolapse,POP)是指由于盆底支持结构薄弱导致的盆腔器官疝出.动态MRI为无放射性、无创、快捷、全面、高分辨率的检查方法,其软组织对比性强,可清晰显示静息位及动态位时盆底肌肉和筋膜组织结构及功能上的变化,了解盆腔多组织器官的状况,为临床提供客观影像学数据.动态MRI常用于膀胱脱垂与膨出、子宫和阴道脱垂、直肠脱垂及肠疝的诊断,有多种检查技术和方法.目前国内还没有统一的POP诊断的影像标准,其诊断多参照美国UCLA的标准,采取HMO分度系统,但是否适合于我国人种,尚需进一步探讨.总之,动态MRI可综合评价盆腔器官脱垂,是研究活体盆底解剖、形态和运动的重要方法;特别是动态MRI结合排粪造影术,除了临床评价外,对指导盆底功能障碍性疾病的跨学科治疗也具有一定作用.展开更多
文摘Background:The most prevalent type of gynecological cancer is endometrial cancer.Accurate surgical staging is the most important aspect in the management of endometrial cancer.Preoperative evaluation of myometrial invasion and appropriate management could be achieved by transvaginal sonography and pelvic MRI.Methods:A total of 53 patients with endometrial cancer,who were referred to a gynecology oncology department of an academic hospital in Mashhad University of Medical Sciences from 2018 to 2020,were evaluated in this study.Data were collected using a questionnaire on endometrial cancer.All the patients underwent preoperative transvaginal sonography and pelvic MRI to evaluate myometrial invasion.The involvement of myometrium thickness and histological findings were compared between two imaging modalities,and SPSS 23.0 was used to analyze the data.Results:Junctional irregularity was the most prevalent finding on transvaginal sonography.Based on transvaginal sonography,myometrial invasion of less than 50%was found in 73%of patients,while invasion of more than 50%was observed in 26.31%.In 57.44%of MRIs,there was less than 50%myometrial invasion,while in 42.55%of MRIs,there was more than 50%myometrial invasion.In both modalities,the most common finding was myometrial invasion of less than 50%.The accuracy,sensitivity,and specificity of transvaginal sonography were 0.47,0.27,and 0.75,respectively,whereas the accuracy,sensitivity,and specificity of MRI were 0.54,0.45,and 0.61,respectively.Conclusion:MRI can be the modality of choice for evaluating myometrial invasion and optimizing endometrial cancer treatment planning,as well as reducing the complications of non-indicated lymphadenectomy.
文摘目的:探讨超声与核磁共振(MRI)在鉴别女性盆腔肿物中的诊断价值。方法:选取2020年1月-2022年12月于宜昌市中心人民医院行手术治疗的65例女性盆腔肿物患者,收集所有患者的临床资料,内容包括术前超声及MRI检查结果、术后病理资料等。结果:在盆腔肿物的定位诊断中,MRI检查的准确率高于超声(95.38%vs 83.08%,P<0.05),其中腹膜内肿物MRI定位符合率97.92%,超声定位符合率为93.75%;腹膜后肿物MRI定位符合率88.24%,超声定位符合率为52.94%。在盆腔肿物诊断良恶性方面,MRI检查的灵敏度(98.00%vs 92.00%)、特异度(86.67%vs 66.67%)和符合率(95.38%vs 86.15%)均优于超声检查组。良性病变最常见的病理类型为子宫肌瘤、卵巢囊肿及输卵管积液/积脓,恶性病变最常见的病理类型为腹膜后淋巴肿瘤、卵巢恶性肿瘤。本研究发现腹膜内与腹膜后肿物平均直径差异有统计学意义(4.5±1.7 cm vs 7.9±3.4 cm)(P<0.05)。结论:MRI在女性盆腔肿物定位及良恶性鉴别诊断方面均优于超声。
文摘盆腔器官脱垂(pelvic organ prolapse,POP)是指由于盆底支持结构薄弱导致的盆腔器官疝出.动态MRI为无放射性、无创、快捷、全面、高分辨率的检查方法,其软组织对比性强,可清晰显示静息位及动态位时盆底肌肉和筋膜组织结构及功能上的变化,了解盆腔多组织器官的状况,为临床提供客观影像学数据.动态MRI常用于膀胱脱垂与膨出、子宫和阴道脱垂、直肠脱垂及肠疝的诊断,有多种检查技术和方法.目前国内还没有统一的POP诊断的影像标准,其诊断多参照美国UCLA的标准,采取HMO分度系统,但是否适合于我国人种,尚需进一步探讨.总之,动态MRI可综合评价盆腔器官脱垂,是研究活体盆底解剖、形态和运动的重要方法;特别是动态MRI结合排粪造影术,除了临床评价外,对指导盆底功能障碍性疾病的跨学科治疗也具有一定作用.
