经阴道超声、磁共振成像和彩色多普勒血流成像判断子宫内膜癌深肌层侵犯的准确性研究  

Accuracy of transvaginal ultrasound, magnetic resonance imaging and color Doppler flow imaging of detecting deep myometrial invasion of endometrial carcinoma

作　　者：席晓薇[1] 李双弟[1] 万小平[1] 陆贤伟[1] 许玉成[2] 何之彦[3] 

机构地区：[1]上海交通大学附属第一人民医院妇产科,200080 [2]上海交通大学附属第一人民医院B超室,200080 [3]上海交通大学附属第一人民医院放射科,200080

出　　处：《上海医学》2004年第9期633-635,共3页Shanghai Medical Journal

摘　　要：目的　比较经阴道超声 (TVUS)、磁共振成像 (MRI)和彩色多普勒血流成像 (CDFI)在术前诊断子宫内膜癌深肌层侵犯的准确性。方法　 30例子宫内膜癌患者术前 1周内行TVUS、MRI和CDFI检查。按肿瘤侵犯深度将其分为无肌层侵犯或浅肌层侵犯组和深肌层侵犯组。比较TVUS、MRI和CDFI检查所见与组织学检查结果 ,计算各诊断技术的灵敏度、特异度、准确性、阳性预测值和阴性预测值。采用Cochran’sQ法比较各诊断学参数。结果　组织学检查证实 ,7例子宫肌层无侵犯 ,17例子宫浅肌层侵犯 ,6例子宫深肌层侵犯。TVUS、MRI和CDFI判断深肌层侵犯的灵敏度分别为 83.3%、6 6 .6 %和 83.3% ,特异度分别为 91.4 %、87.5 %和83.3% ,准确性分别为 90 .0 %、83.3%和 83.3%。TVUS、MRI和CDFI 3种技术诊断深肌层侵犯的灵敏度、特异度和准确性的差异无显著性。结论　与较为昂贵、耗时的MRI或CDFI检查比较 。Objective To compare the accuracy of transvaginal ultrasound (TVUS), magnetic resonance imaging (MRI) and color Doppler flow imaging(CDFI) in detecting deep myometrial invasion of endometrial carcinoma.Methods Thirty consecutive patients with endometrial carcinoma in our hospital between 2002.8～2003.8 were evaluated with TVUS, MRI and CDFI within one week before surgery. These patients were divided into two groups: absent or superficial and deep myometrial invasion groups. TVUS, MRI and CDFI findings were correlated with the pathological results. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of each method were compared with those by Cochran's Q test.Results In the pathological examination, myometrial invasion was absent in 7 patients, superficial myometrial invasion in 17 patients, and deep ones in 6 patients. The sensitivity / specificity / accuracy of TVUS, MRI and CDFI in detecting deep myometrial invasion were 83.3% / 91.4%- / 90.0% , 66.6%/ 87.5%/ 83.3%, and 83.3% / 83.3% / 83.3%, respectively. There was no significant difference among TVUS, MRI, and CDFI. Conclusions In our experience, after comparing with the more expensive, time-comsuming MRI or CDFI, TVUS is still a simple and useful technique in detection of deep myometrial invasion for endometrial earcinoma.

关 键 词：CDFI MRI 子宫内膜癌 特异度 彩色多普勒血流成像 磁共振成像 经阴道超声 例子 灵敏度 参数 

分 类 号：R737.33[医药卫生—肿瘤] R714[医药卫生—临床医学]