子宫内膜癌磁共振成像的诊断价值分析  

Magnetic resonance imaging in diagnosis of endometrial cancer

作　　者：李丹 焦永慧[1] 刘宗谕 杨瑞琦[2] 范丽梅[2] Li Dan;Jiao Yonghui;Liu Zongyu;Yang Ruiqi;Fan Limei(Department of Reproductive Medicine,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Gynecology and Obstetrics,the Second Hospital of Jilin University,Changchun 130041,China)

机构地区：[1]新疆维吾尔自治区人民医院生殖医学科,乌鲁木齐830001 [2]吉林大学第二医院妇产科,长春130041

出　　处：《中华全科医师杂志》2021年第7期773-776,共4页Chinese Journal of General Practitioners

摘　　要：回顾性分析2017年6月至2019年12月吉林大学第二医院及新疆维吾尔自治区人民医院经诊断性刮宫检查后行手术治疗的199例子宫内膜癌患者的临床资料。所有资料数据均采用SPSS 21.0软件分析。以术后病理分期为金标准,术前磁共振成像(MRI)对子宫内膜癌分期诊断的准确率为85.9%(171/199)。MRI对肌层浸润、宫颈浸润、淋巴结转移评估的准确性与病理诊断具有中度一致性,Kappa值分别为0.353、0.574、0.573(均P<0.05)。MRI诊断肌层浸润的敏感性为45.2%(19/42),特异性为88.5%(139/157),阳性预测值为51.4%(19/37),阴性预测值为85.8%(139/162),准确率为79.4%(158/199)。MRI诊断宫颈浸润的敏感性为58.3%(14/24),特异性为96.0%(168/175),阳性预测值为66.7%(14/21),阴性预测值为94.4%(168/178),准确率为91.5%(182/199)。MRI诊断淋巴结转移的敏感性为12/18,特异性为95.6%(173/181),阳性预测值为60.0%(12/20),阴性预测值为96.6%(173/179),准确率为93.0%(185/199)。提示MRI对子宫内膜癌术前分期诊断具有较高的准确性和阴性预测率,是评估子宫内膜癌较准确的方法。The study is to explore the diagnostic value of magnetic resonance imaging(MRI)for endometrial carcinoma.Clinical data of 199 patients with endometrial cancer confirmed by diagnostic uterine curettage in the Second Hospital of Jilin University and the People′s Hospital of Xinjiang Uygur Autonomous Region from June 2017 to December 2019 were reviewed retrospectively.The data were analyzed by SPSS 21.0 software.MRI scan was performed before operation,the diagnostic accuracy of MRI for the preoperative staging of endometrial carcinoma was 85.9%(171/199)with postoperative pathological results as gold standard.The Kappa values of muscular infiltration,cervical infiltration and lymph node metastasis were 0.353,0.574 and 0.573,respectively(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy for myometrial invasion on MRI were 45.2%(19/42),88.5%(139/157),51.4%(19/37),85.8%(139/162)and 79.4%(158/199),respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy for cervical invasion on MRI were 58.3%(14/24),96.0%(168/175),66.7%(14/21),94.4%(168/178)and 91.5%(182/199),respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy for lymph node metastasis on MRI were 12/18,95.6%(173/181),60.0%(12/20),96.6%(173/179)and 93.0%(185/199),respectively.The results indicate that MRI has high accuracy and negative predictive rate in evaluation of preoperative staging of endometrial cancer.

关 键 词：子宫内膜肿瘤 磁共振成像 肿瘤分期 

分 类 号：R737.33[医药卫生—肿瘤]