早期子宫内膜癌MRI与手术病理分期的比较研究  

Comparative Study of MRI and Surgery-Pathology of Stage Ⅰ-Ⅱ Endometrial Carcinoma

作　　者：殷胜利[1] 龚华荣[2] 李文华[2] 崔艳芬[2] 张萍[2] 吴相如[2] 汤蕴琦[2] 

机构地区：[1]上海交通大学医学院附属新华医院(崇明)放射科,上海200092 [2]上海交通大学医学院附属新华医院,上海200092

出　　处：《中国医药指南》2012年第26期3-5,共3页Guide of China Medicine

基　　金：上海市卫生局(2008184)

摘　　要：目的与手术病理分期比较,回顾性分析MRI对早期子宫内膜癌术前分期的准确性和判断肿瘤分级的价值。方法对122例经分段诊刮和手术病理证实的早期(Ⅰ-Ⅱ期)子宫内膜癌病例进行MR自旋回波T1WI、T2WI和DWI成像检查,观察肿瘤的信号、肿瘤范围、结合带显示及宫颈累及情况,测量ADC值,并进行T2WI和T2WI+DWI分期。结果 Ia期25例,Ib期64例;Ⅱ期33例。与正常子宫内膜相比,肿瘤T1WI呈等信号,T2WI呈高信号,DWI为明显高信号,增强后表现为中度强化。T2WI分期的敏感度为89.3%,特异度为91.0%,T2WI+DWI分期的敏感度为94.3%,特异度为93.5%。结论 T2WI联合DWI更有利于提高早期子宫内膜癌分期的准确性和判断肿瘤的分化程度。Objective To retrospectively evaluate the value of preoperative staging and grading of MR imaging compared with surgery-pathology proved Stage Ⅰ-Ⅱ Endometrial Carcinoma.Methods One hundred and twenty-two patients with pathological1y proved endometrial carcinomas were included in this retrospective study.All patients underwent spin-echo MR Tl-and T2-weighted imaging and diffusion-weighted imaging（DWI） and gadolinium-enhanced T1-weighted imaging.The signals,extent,appearance of junctional zone,depth of myometrial invasion and cervical invasion were recorded.The value of ADC measurement and tumor staging using T2-weighted imaging and combining T2-weighted imaging and DWI were performed.Results Of 122 patients,25 were Ia,64 were Ib,33 were II stage.All tumors were isointensity on T1-weighted images,hyperintensity on T2-weighted images and DWI with moderate enhancement compared with the normal endometrium.The sensitivity and specificity of tumor staging using T2-weighted imaging was 89.3% and 91.0% and combining T2-weighted imaging and DWI was 94.3% and 93.5% retrospectively.Conclusion The accuracy of staging of early endometrial carcinoma can be promoted and the tumor grading may be further evaluated with combining T2-weighted imaging and DWI.

关 键 词：子宫内膜癌 肿瘤分期 磁共振成像 

分 类 号：R737.33[医药卫生—肿瘤]