子宫内膜癌MRI多模态表现与临床病理对照研究  

MRI Multimodal Manifestations and Clinicopathological Control of Endometrial Carcinoma

作　　者：王丹[1] 秦珍珠[1] 梁运霞[1] 张玉文[1] 陈琪璇 WANG Dan;QIN Zhen-zhu;LIANG Yun-xia(Department of Pathology,Shangqiu First People's Hospital,Shangqiu 476100,Henan Province,China)

机构地区：[1]河南省商丘市第一人民医院病理科,河南商丘476100

出　　处：《中国CT和MRI杂志》2020年第3期33-36,共4页Chinese Journal of CT and MRI

基　　金：河南省卫生和计划委员会科技项目(编号:142102316089)。

摘　　要：目的探讨子宫内膜癌常规MRI、DWI和动态增强扫描临床特征及其与病理对照的价值。方法选取2016年6月至2018年7月在我院诊治的子宫内膜癌患者132例,术前进行常规MRI、DWI、DCEMRI扫描,评估不同成像方法临床影像特征以及子宫内膜肌层浸润和术前分期情况,并与病理结果进行对比,分析其检查结果与病理分级关系。结果 DWI诊断病灶浸润深度与术后病理结果比较,灵敏度与特异度高于常规MRI与DCE-MRI诊断,差异有统计学意义(P<0.05);常规MRI诊断ⅠA期36例(66.66%)、ⅠB期28例(73.68%)、Ⅱ期17例(60.71%)、Ⅲ期7例(58.33%),与病理一致性检验结果Kappa值=0.691,P=0.000;DWI诊断ⅠA期45例(83.33%)、ⅠB期34例(89.47%)、Ⅱ期24例(85.71%)、Ⅲ期12例(100.00%),与病理结果一致性检验结果K a p p a值=0.825,P=0.000;DCE-MRI诊断ⅠA期41例(75.92%)、ⅠB期32例(84.21%)、Ⅱ期20例(71.42%)、Ⅲ期10例(83.33%),与病理结果一致性检验结果Kappa值=0.777,P=0.000。结论 DWI较常规MRI与DCE-MRI对子宫内膜癌患者浸润状态及分期判断效能更高,与病理结果一致性较好。Objective To investigate the clinical features of conventional MRI, DWI and dynamic contrast-enhanced scanning of endometrial carcinoma and its value in comparison with pathology. Methods A total of 132 patients with endometrial cancer treated in our hospital from June 2016 to July 2018 were enrolled. Preoperative MRI, DWI, and DCEMRI scans were performed. The clinical imaging features of different imaging methods, as well as endometrial myometrial invasion and preoperative staging were evaluated and compared with pathological results. The relationship between the results and pathological grades was analyzed. Results The sensitivity and specificity of DWI in diagnosis of invasive depth compared with postoperative pathological results were higher than those of conventional MRI and DCE-MRI. The difference was statistically significant(P<0.05). Routine MRI correctly diagnosed endometrial cancer in IA stage 36 cases(66.66%), IB stage 28 cases(73.68%), stage II 17 cases(60.71%), stage III 7 cases(58.33%), Kappa value=0.0091, P=0.000;DWI correctly diagnosed endometrial cancer in IA stage in 45 cases(83.33%), IB stage 34 cases(89.47%), stage II 24 cases(85.71%), stage III 12 cases(100.00%), Kappa value=0.825, P=0.000. DCE-MRI correctly diagnosed endometrial cancer in IA stage 41 cases(75.92%), IB stage 32 cases(84.21%), stage II 20 cases(71.42%), stage III 10 cases(83.33%), Kappa value=0.777, P=0.000. Conclusion Compared with DCE-MRI, DWI has higher efficacy in preoperative infiltration and staging diagnosis of endometrial cancer patients, and has higher consistency with postoperative pathological results.

关 键 词：动态增强扫描 子宫内膜癌 病理分期 肌层浸润 

分 类 号：R711.32[医药卫生—妇产科学]