MRI在子宫内膜癌FIGO2009新分期中的作用  

Value of magnetic resonance imaging in preoperative staging of endometrial carcinoma according to International Federation of Gynecology and Obstetrics(2009) staging criteria

作　　者：杜立新[1] 雷益[1] 李顶夫[1] 邱喜雄[1] 梁碧玲[2] 

机构地区：[1]深圳大学第一附属医院放射科,广东深圳518035 [2]中山大学孙逸仙纪念医院放射科,广东广州510120

出　　处：《南方医科大学学报》2012年第7期1048-1051,共4页Journal of Southern Medical University

摘　　要：目的分析子宫内膜癌的磁共振成像(MRI)征象,探讨MRI在子宫内膜癌新分期中的作用。方法对54例术后经病理证实并具有完整临床资料的子宫内膜癌患者术前行MRI检查,描述肿瘤的MRI征象特点,以FIGO2009最新分期为标准,对MRI判断肌层侵犯、宫颈浸润及术前分期的结果进行评价。结果 54例子宫内膜癌中,Ⅰa期27例,Ⅰb期9例,Ⅱ期10例,Ⅲ期5例,Ⅳ期3例。MRI对病灶的总显示率达94%(51/54)。T1WI肿瘤显示欠清,T2WI呈中等偏高信号,增强时中等强化,低于明显强化的肌层。结合T2WI及T1WI脂肪抑制序列增强扫描,MRI评价肿瘤浸润肌层深度的准确性为91%(49/54),正确判断宫颈侵犯的敏感性为77%,特异性89%,准确性83%,MRI对子宫内膜癌分期准确率为89%(48/54),与术后FIGO新分期、病理结果对照,无统计学差异(P>0.05)。结论 MRI对子宫内膜癌诊断、肌层/宫颈侵犯的判断及术前分期准确性高,是临床制定治疗方案和预后评估的重要影像学检查手段。Objective To analyze the magnetic resonance imaging （MRI） features of endometrial carcinoma and their value in endometrial carcinoma staging according to the International Federation of Gynecology and Obstetrics （FIGO 2009） staging criteria. Methods Fifty-four patients with pathologically confirmed endometrial carcinoma and complete clinical data underwent preoperative MRI examination. According to FIGO 2009 staging criteria of endometrial carcinoma, the MRI features of the tumor lesions were evaluated for assessment of myometrial invasion and cervical involvement and preoperative staging. Results The 54 cases included 27 stage Ia cases, 9 stage Ib cases, 10 stage Ⅱ cases, 5 stage Ⅲ cases, and 3 stage Ⅳ cases. The total lesion display rate by MRI was 94% （51/54）. With an isointensity or hypo-intensity on TIWI, the tumor lesions showed a moderate hyper-intensity on T2WI. In enhanced MRI scanning, the lesions showed a moderate heterogeneous enhancement, which had a lower intensity than the marked enhancement of the myometrium. Combination of T2WI and T1WI in fat suppression sequence enhanced scan had a diagnostic accuracy of 91% （49/54） for myometrial invasion, and the sensitivity, specificity and accuracy of MRI for detecting cervical involvement were 77%, 89%, and 83%, respectively. The accuracy of preoperative MRI-based staging of endometrial carcinoma was 89% （48/54）, showing no significant difference from the results of postoperative FIGO 2009 staging and pathological examination （P〉0.05）. Conclusion MRI has a high accuracy in the diagnosis, evaluation of myometrial and cervical invasion depth, and preoperative staging of endometrial carcinoma, and serves as an important modality in assisting clinical decisions on the optimal therapeutic protocols and in prognostic estimation.

关 键 词：子宫内膜癌 磁共振成像 肿瘤分期 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]