磁共振扩散加权成像在Ⅰ期子宫内膜癌肌层浸润中的诊断价值  

The Value of Diffusion-Weighted MR Imaging in Differentiating the Myometrial Invasion of Endometrial Carcinoma StageⅠ

作　　者：邓凯[1] 张成琪[1] 李伟[1] 王广丽[1] 董桂青[1] 

机构地区：[1]山东大学附属千佛山医院CT-MR室,山东济南250014

出　　处：《实用妇产科杂志》2014年第11期831-835,共5页Journal of Practical Obstetrics and Gynecology

基　　金：山东省科技攻关计划项目(编号:2012YD18060)

摘　　要：目的:探讨磁共振扩散加权成像(DWI)在Ⅰ期子宫内膜癌肌层浸润中的诊断价值。方法:回顾性分析42例术后病理检查证实为Ⅰ期子宫内膜癌患者术前磁共振(MR)检查资料,分别采用DWI和磁共振动态增加扫描(DCE)图像分析肿瘤肌层浸润深度,并与手术病理结果对照。结果:DWI和DCE图像诊断肿瘤浸润子宫浅肌层的敏感度、特异度分别为83.3%、91.7%和88.9%、95.8%;诊断肿瘤浸润子宫深肌层的敏感度、特异度分别为91.7%、83.3%和95.8%、88.9%,两种方法比较,差异无统计学意义(P>0.05)。DWI序列诊断肿瘤浸润浅、深肌层的ROC曲线下面积(AUC)分别为0.800、0.705,与DCE(0.833、0.750)相比,差异无统计学意义(P>0.05)。结论:DWI对判断Ⅰ期子宫内膜癌肌层浸润具有较高的诊断价值,与DCE均可作为优选序列用于子宫内膜癌的术前分期。Objective：To study the application value of diffusion-weighted imaging（DWI） for the evaluation of myometrial infiltration in endometrial carcinoma stage I, compared with MR dynamic contrast enhancement （DCE）. Methods：The data of 42 patients with endometrial carcinoma stage I proved by post-operative pathology were analyzed retrospectively. All patients underwent DWI and DCE MR scan before operation. The diagnosis of myometrial invasion were correlated with the pathologic results. Results：Compared with pathologic results,the sensitivity and specificity of DWl and DCE MR assessment for tumor confined to superficial myometrial invasion were 83.3% ,91.7% and 88.9%, 95. 8%, respectively;to deep myometrial invasion were 91.7% ,83.3% and 95.8% ,88.9%, respectively. No significant difference was found between DWl and DCE （ P 〉 0. 05）. The area under ROC curve（AUC） of DWI assessment for tumor confined to superficial and deep myometrial invasion were 0. 800,0. 705, respectively. No significant difference was found between DWl and DCE （0. 833,0. 750 ） （ P 〉 0.05）. Conclusions：Diffusion-weighted imaging has considerable value in differentiating myometrial invasion of endometrial carcinoma stage I. Both DWl and DCE MR imaging can be selected for assessing the invasion of myometrium before operation.

关 键 词：磁共振成像 扩散加权成像 动态增强扫描 子宫内膜癌 肌层浸润 

分 类 号：R737.33[医药卫生—肿瘤]