3DT2WI对子宫内膜癌分期的诊断效能  

Diagnostic efficacy of 3D T2 WI for staging of endometriai carcinoma

作　　者：朱颖[1] 朱天照[1] 王岳[1] 孙红霞[1] Queenie Chan 王霄英[1] 蒋学祥[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034 [2]飞利浦医疗保健事业部

出　　处：《实用放射学杂志》2012年第12期1827-1830,共4页Journal of Practical Radiology

摘　　要：目的 评价3DT2WI在子宫内膜癌MR盆腔检查的图像质量及肿瘤检出和分期的应用价值。方法 前瞻性收集30例子宫内膜癌首诊病例，盆腔MR检查轴位、斜冠状位、矢状位T2扫描，时间共12min 48s。3DT2WI扫描时间5min56s。所有病例的2D和3D图像分别进行图像质量定性评价。包括肿瘤可视度、图像质量、运动伪影等指标。对所有病例2DT2WI和3DT2WI进行肿瘤分期评价的一致性分析。对有手术病理对照的病例，评价2DT2WI和3DT2WI的诊断准确性。结果 30个病例，病灶可视度评分3DT2WI显著优于2DT2WI（t=2．19，P=0．04），两者运动伪影无显著差异（t=-0．17，P=0．87）。2D和3DT2WI对肌层浸润深度和宫颈浸润的评价Kappa值分别为0．81和0．87，一致性均较好。对15例有手术病理的病例，肌层浸润深度的准确度2D和3DT2W1分别为80％（12／15）和86．7％（13／15）。结论3DT2WI可以获得与2DT2WI相似的图像质量和诊断分期准确度．并能提高子宫内膜癌病灶的可视度，节省扫描时间。Objective To evaluate 3D T2-weighted imaging sequence for tumor detection and staging of endometrial carcinoma（EC）, as well as image quality. Methods Thirty female patients （age range, 27-76 years） with EC underwent MRI of pelvis with multi planar 2D T2WI and 3D T2W1. The acquisition time for 2D sequences was 12 minutes 48 seconds, whereas the acquisition time for 3D sequence was 5 minutes 56 seconds. The reader assessed image quality and staging of EC for each sequence. Paired samples t test was used to compare the image quality. The agreement between 2D and 3D T2 WI was assessed with kappa coefficients. The accuracy of the staging was calculated with the correlation of the pathology. Results The tumor conspicuity on 3D T2WI was superior to that on 2D T2WI （t=2.19,P=0.04）. There was no significant difference in motion artifacts （t=-0. 17,P=0.87）. For myo- metrial and cervical involvement, there was fair agreement between2Dand3DT2WI （k=0.81, k=0.87）. The accuracy of the eval- uation of involvement depth on 213 and 3DT2WI was 80% （12/15） and 86.7% （13/15）. Conclusion 3DT2WI had similar image quality and accuracy of staging in endometrial carcinoma in comparison with conventional 2D T2WI. Besides, 3D T2 WI improvedtumor conspicuity and saved scanning time.

关 键 词：子宫 子宫内膜癌 三维 磁共振成像 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]