MRI动态增强扫描在子宫恶性肿瘤分期中的价值  

Value of MRI Dynamic Enhanced Scanning in the Staging of Uterine Malignant Tumors

作　　者：岳美淋 周作福[1] 陈霞平[1] 李尔煊 刘朝禄[1] YUE Mei-lin;ZHOU Zuo-fu;CHEN Xia-ping;LI Er-xuan;LIU Chao-lu(Department of Imaging,Fujian Provincial Maternity and Children's Hospital,Affiliated Hospital of Fujian Medical University,Fuzhou City,Fujian Province,350001,China)

机构地区：[1]福建省妇幼保健院/福建医科大学附属医院影像科

出　　处：《蛇志》2019年第3期336-338,共3页Journal of Snake

摘　　要：目的探讨MRI动态增强扫描诊断子宫恶性肿瘤分期的价值。方法选取2016年11月~2017年11月我院收治的经病理确诊为子宫恶性肿瘤患者43例,所有患者术前给予横断面T1WI、横断面T2WI、矢状面T2WISTIR、Gd-DTPA动态增强矢状面、常规横断面以及矢状面T1WI增强扫描,分析动态增强扫描与常规序列扫描的肿瘤图像、结合带及子宫肌层情况,评估MRI动态增强扫描诊断子宫恶性肿瘤分期的价值。结果MRI动态增强扫描图像可见子宫结合带和子宫肌层显示良好,且未见明显侵犯;DCE-MRI(动脉晚期)可见子宫后下方结合带部分毛糙,并累及浅肌层。43例子宫恶性肿瘤患者中,术后病理Ⅰ期36例,其中Ⅰa期6例,Ⅰb期25例,Ⅰc期5例;Ⅱ期5例;Ⅲ期2例。4例子宫内膜间质肉瘤患者均为Ⅱ期。术后病理检测诊断子宫内膜癌Ⅰa期和Ⅱ期准确率均高于常规序列组(P<0.05);常规序列扫描与动态增强扫描诊断Ⅰb期和Ⅱ期的准确率比较,差异有统计学意义(P<0.05)。结论MRI动态增强扫描诊断子宫恶性肿瘤有显著价值,能够清晰显示子宫恶性肿瘤范围和组织侵犯情况,对手术前分期以及治疗措施的选择有指导意义。Objective To discuss the value of MRI dynamic contrast enhanced scaning in the diagnosis of uterine malignant tumors staging. Methods 43 patients with uterine malignant tumors diagnosed by pathology in our hospital from November 2016 to November 2017 were enrolled.All patients underwent transverse T1WI,transverse T2WI,sagittal T2WI STIR,Gd DTPA dynamic enhanced sagittal,conventional transverse and sagittal T1WI enhanced scanning before operation and analyzed tumor images,binding bands and uterine myometrium of dynamic enhanced scanning and conventional sequence scanning to evaluate the value of dynamic contrast-enhanced MRI scan in the diagnosis of uterine malignant tumors staging.Results Dynamic contrast-enhanced MRI showed that the uterine junction zone and myometrium were well displayed without obvious invasion.DCE-MRI (late arterial phase) showed partial roughness of the posterior inferior junction zone of the uterus and involved the superficial myometrium.Among the 43 patients with uterine malignant tumors,36 cases had postoperative pathology of stage 1,including6 cases of stage Ⅰa,25 cases of stage Ⅰb,5 cases of stage Ⅰc,5 cases of stage Ⅱ and 2 cases of stage Ⅲ.4 patients with endometrial stromal sarcoma were stage Ⅱ.The accuracy of pathological examination in diagnosis of stage Ia and Ⅱ of endometrial cancer after operation was higher than that of conventional sequence group ( P<0.05).There was statistically significant difference between conventional sequence scan and dynamic contrast-enhanced scan in diagnosis of stage Ib and Ⅱ in endometrial cancer ( P <0.05).. Conclusion Dynamic contrast-enhanced MRI scanning has significant valuein the diagnosis of patients with uterine malignant tumors.It can clearly show the extent of uterine malignant tumors and tissue invasion and has significant significance for preoperative staging and treatment options.

关 键 词：MRI 动态增强扫描 子宫恶性肿瘤 分期 价值 

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]