磁共振成像在子宫内膜癌术前评估中的临床应用  

Clinical Application of Magnetic Resonance Imaging in Preoperative Evaluation of Endometrial Cancer

作　　者：任翠[1] 薛华丹[1] 李烁[1] 张洁[1] 潘卫东[1] 孙兆勇[1] 房洪营[1] 孙宏毅[1] 金征宇[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730

出　　处：《中国医学科学院学报》2012年第5期455-460,共6页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨磁共振成像在子宫内膜癌术前评估中的临床应用价值。方法回顾性收集94例经手术病理证实的子宫内膜癌患者,将术前磁共振成像检查结果与手术病理结果对照,评价T2加权像(T2WI)结合增强扫描或弥散加权成像(DWI)判断子宫内膜癌肌层浸润深度及淋巴结转移的价值。结果 94例子宫内膜癌中,无或浅肌层浸润的子宫内膜癌62例、深肌层浸润的子宫内膜癌32例;24组转移性淋巴结、164组非转移性淋巴结。T2WI结合增强扫描或DWI鉴别无/浅肌层浸润和深肌层浸润的准确率、特异性、敏感性、阴性及阳性预测值分别为88.3%、90.3%、84.4%、91.8%、81.8%和81.9%、87.1%、71.9%、85.7%、74.2%。T2WI结合增强扫描、DWI判断淋巴结转移的准确率、特异性、敏感性、阴性及阳性预测值分别为89.4%、96.8%、54.5%、90.9%、78.3%和91.5%、95.5%、72.7%、94.3%、77.4%。结论磁共振成像T2WI结合增强扫描判断子宫内膜癌肌层浸润深度的能力优于T2WI结合DWI,DWI鉴别淋巴结转移较T2WI结合增强扫描更敏感。Objective To investigate the value of magnetic resonance imaging （MRI） in the preoperative assessment of endometrial cancer. Methods Ninety-four patients with histopathologically confirmed endometrial carcinoma were retrospectively enrolled in this study. MRI findings were compared with the pathologic findings in all cases. The depth of myometrial invasion and lymph node metastasis were evaluated by T2 weighted imaging （rr2wI） combined with contrast enhancement or diffusion weighted imaging （DWI）. Results A- mong these 94 patients, 62 had no or superficial myometrial involvement and 32 cases had deep myometrial in- volvement. Meanwhile, 24 groups of metastatic lymph nodes and 164 groups of non-metastatic lymph nodes were detected. The accuracy, specificity, sensitivity, negative predictive value, and positive predictive value of T2WI combined with contrast enhancement in discriminating no/superficial myometrial involvement from deep myometrial involvement were 88.3% , 90.3% , 84.4% , 91.8% , and 81.8% , whereas those of T2WI combined with DWI were 81.9% , 87.1% , 71.9% , 85.7% , and 74.2% , respectively. The accuracy, specificity, sensitivity, negative predictive value, and positive predictive value of T2WI combined with contrast enhancement in identifying metastatic lymph nodes were 89.4% , 96.8% , 54.5% , 90.9% , and 78.3% , whereas those of T2WI combined with DWI were 91.5% , 95.5% , 72.7% , 94.3% , and 77.4% , respectively. Conclusions T2WI combined with contrast enhancement is superior to T2WI combined with DWI in evaluation of the depth of myometrial invasion. However, DWI is more sensitive in identifying lymph node metastasis than T2WI combined with contrast enhancement.

关 键 词：子宫内膜癌 磁共振成像 弥散加权成像 

分 类 号：R445[医药卫生—影像医学与核医学] R737.3[医药卫生—诊断学]