Introduction: Endometrial cancer is the fourth most frequent cancer in females. Many factors can affect prognosis of this type of cancer, these mainly are the degree of myometrial invasion by the tumour, pelvic and pa...Introduction: Endometrial cancer is the fourth most frequent cancer in females. Many factors can affect prognosis of this type of cancer, these mainly are the degree of myometrial invasion by the tumour, pelvic and paraaortic lymph node spread as well as the tumour histological type (endometrioid vs non-endometrioid type).<span style="font-family:""> </span><span style="font-family:Verdana;">transvaginal ultrasound (TVS) is a highly accurate and easy method for preoperative evaluation of myometrial invasion.</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Aim of </span><span style="font-family:Verdana;">the Work: The aim of this work is to assess if there is relation between the</span><span style="font-family:Verdana;"> depth of myometrial invasion by the tumor and the rate of lymph node involvement in cases of endometrial cancer. Results: It was found that there was </span><span style="font-family:Verdana;">a significant relation between lymph node affection and the depth of myometrial invasion, all the positive lymph node affections cases had myomterial invasion ></span></span><span style="font-family:""> </span><span style="font-family:Verdana;">50.0%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Conclusion: The incidence of pelvic lymph</span><span style="font-family:Verdana;"> node affection is very high in cases where the myometrium is deeply infiltrated with the tumor. Assessment of myometrial invasion preoperatively by TVU and microscopically by pathological examination of the myometrium after hysterectomy provides an accurate estimation of the rate of pelvic lymph node affection and hence necessitates lymphadenectomy procedures in cases where myometrium is deeply infiltrated by the tumor and omitted in cases where it is tumor free.</span>展开更多
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
目的探讨子宫内膜癌常规MRI、DWI和动态增强扫描临床特征及其与病理对照的价值。方法选取2016年6月至2018年7月在我院诊治的子宫内膜癌患者132例,术前进行常规MRI、DWI、DCEMRI扫描,评估不同成像方法临床影像特征以及子宫内膜肌层浸润...目的探讨子宫内膜癌常规MRI、DWI和动态增强扫描临床特征及其与病理对照的价值。方法选取2016年6月至2018年7月在我院诊治的子宫内膜癌患者132例,术前进行常规MRI、DWI、DCEMRI扫描,评估不同成像方法临床影像特征以及子宫内膜肌层浸润和术前分期情况,并与病理结果进行对比,分析其检查结果与病理分级关系。结果 DWI诊断病灶浸润深度与术后病理结果比较,灵敏度与特异度高于常规MRI与DCE-MRI诊断,差异有统计学意义(P<0.05);常规MRI诊断ⅠA期36例(66.66%)、ⅠB期28例(73.68%)、Ⅱ期17例(60.71%)、Ⅲ期7例(58.33%),与病理一致性检验结果Kappa值=0.691,P=0.000;DWI诊断ⅠA期45例(83.33%)、ⅠB期34例(89.47%)、Ⅱ期24例(85.71%)、Ⅲ期12例(100.00%),与病理结果一致性检验结果K a p p a值=0.825,P=0.000;DCE-MRI诊断ⅠA期41例(75.92%)、ⅠB期32例(84.21%)、Ⅱ期20例(71.42%)、Ⅲ期10例(83.33%),与病理结果一致性检验结果Kappa值=0.777,P=0.000。结论 DWI较常规MRI与DCE-MRI对子宫内膜癌患者浸润状态及分期判断效能更高,与病理结果一致性较好。展开更多
文摘Introduction: Endometrial cancer is the fourth most frequent cancer in females. Many factors can affect prognosis of this type of cancer, these mainly are the degree of myometrial invasion by the tumour, pelvic and paraaortic lymph node spread as well as the tumour histological type (endometrioid vs non-endometrioid type).<span style="font-family:""> </span><span style="font-family:Verdana;">transvaginal ultrasound (TVS) is a highly accurate and easy method for preoperative evaluation of myometrial invasion.</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Aim of </span><span style="font-family:Verdana;">the Work: The aim of this work is to assess if there is relation between the</span><span style="font-family:Verdana;"> depth of myometrial invasion by the tumor and the rate of lymph node involvement in cases of endometrial cancer. Results: It was found that there was </span><span style="font-family:Verdana;">a significant relation between lymph node affection and the depth of myometrial invasion, all the positive lymph node affections cases had myomterial invasion ></span></span><span style="font-family:""> </span><span style="font-family:Verdana;">50.0%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Conclusion: The incidence of pelvic lymph</span><span style="font-family:Verdana;"> node affection is very high in cases where the myometrium is deeply infiltrated with the tumor. Assessment of myometrial invasion preoperatively by TVU and microscopically by pathological examination of the myometrium after hysterectomy provides an accurate estimation of the rate of pelvic lymph node affection and hence necessitates lymphadenectomy procedures in cases where myometrium is deeply infiltrated by the tumor and omitted in cases where it is tumor free.</span>
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.
文摘目的探讨子宫内膜癌常规MRI、DWI和动态增强扫描临床特征及其与病理对照的价值。方法选取2016年6月至2018年7月在我院诊治的子宫内膜癌患者132例,术前进行常规MRI、DWI、DCEMRI扫描,评估不同成像方法临床影像特征以及子宫内膜肌层浸润和术前分期情况,并与病理结果进行对比,分析其检查结果与病理分级关系。结果 DWI诊断病灶浸润深度与术后病理结果比较,灵敏度与特异度高于常规MRI与DCE-MRI诊断,差异有统计学意义(P<0.05);常规MRI诊断ⅠA期36例(66.66%)、ⅠB期28例(73.68%)、Ⅱ期17例(60.71%)、Ⅲ期7例(58.33%),与病理一致性检验结果Kappa值=0.691,P=0.000;DWI诊断ⅠA期45例(83.33%)、ⅠB期34例(89.47%)、Ⅱ期24例(85.71%)、Ⅲ期12例(100.00%),与病理结果一致性检验结果K a p p a值=0.825,P=0.000;DCE-MRI诊断ⅠA期41例(75.92%)、ⅠB期32例(84.21%)、Ⅱ期20例(71.42%)、Ⅲ期10例(83.33%),与病理结果一致性检验结果Kappa值=0.777,P=0.000。结论 DWI较常规MRI与DCE-MRI对子宫内膜癌患者浸润状态及分期判断效能更高,与病理结果一致性较好。
