动态增强MRI和超声3D-TVS技术在子宫内膜癌分期诊断中的对比研究  

Comparative study of DCE-MRI and 3D-TVS technique in the staging diagnosis of endometrial carcinoma

作　　者：钟玲[1] 毛晓丽[1] 周波[1] 蔡青蓉[1] 黄波[1] 陈慧敏[1] ZHONG Ling;MAO Xiao-li;ZHOU Bo(Department of Function,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430000,China.)

机构地区：[1]武汉市中医医院功能科,湖北武汉430000

出　　处：《中国医学装备》2021年第9期75-78,共4页China Medical Equipment

摘　　要：目的:分析动态增强磁共振成像(DCE-MRI)和经阴道三维超声(3D-TVS)技术在子宫内膜癌(EC)Ⅰ~Ⅳ分期诊断中的对比。方法:选取医院妇科收治的96例EC患者,均通过病理检查确诊,且术前均行DCE-MRI和3D-TVS检查,记录并比较两种检查技术诊断EC患者分期的检查结果,采用受试者工作特征(ROC)曲线,分析DCE-MRI和3D-TVS技术在子宫内膜癌Ⅰ~Ⅳ分期诊断的价值。结果:96例EC患者国际妇产科联盟(FIGO)标准中Ⅰ期50例,Ⅱ期29例,Ⅲ期11例,Ⅳ期6例。病理结果中子宫内膜样腺癌85例(占88.54%),乳头状腺癌2例(占2.08%),透明细胞癌4例(占4.17%),腺鳞癌5例(占5.21%);肿瘤分化程度中高分化31例(占32.29%),中分化52例(占54.17%),低分化或未分化13例(占13.54%)。DCE-MRI检查不同病理分期容积转运常数(K^(trans))、速率常数(K_(ep))及血管外细胞外容积分数(Ve)水平明显升高,各分期间比较差异有统计学意义(F=51.570,F=12.510,F=22.410;P<0.05);DCE-MRI诊断EC患者总检出率为72.92%。3D-TVS检查不同病理分期子宫体积及肿瘤体积水平明显升高,各分期间比较差异有统计学意义(Z=-2.165,Z=-2.134;P<0.05);3D-TVS诊断EC患者总检出率为77.08%。ROC曲线分析结果,MRI和3D-TVS诊断EC患者分期的曲线下面积(AUC)分别为0.715和0.756。结论:DCE-MRI和3D-TVS技术均可诊断子宫内膜癌各分期,其中3D-TVS技术准确度较高,可更好的指导临床治疗。Objective:To analyze the comparison of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and three-dimensional transvaginal ultrasound(3D-TVS)in the staging diagnosis of stageⅠ~Ⅳof endometrial carcinoma(EC).Methods:96 patients with EC who admitted to gynecological hospital and were confirmed by pathological examination were selected,and DCE-MRI and 3D-TVS were performed on them before surgery.The examination results of the two examination techniques in diagnosing EC staging were recorded and compared.The values of DCE-MRI and 3D-TVS in diagnosing the I~IV staging of EC were analyzed by receiver operating characteristic(ROC)curve.Results:According to the standard of International Federation of Obstetrics and gynecology(FIGO),50 cases were stage I,and 29 cases were stage II,and 11 cases were stage III and 6 cases were stage IV.The pathological results indicated that 85 cases were endometrioid adenocarcinoma(88.54%),and 2 cases were papillary adenocarcinoma(2.08%),and 4 cases were clear cell carcinoma(4.17%),and 5 cases were adenosquamous carcinoma(5.21%).In the degree of tumor differentiation,31 cases(32.29%)were highly differentiation,and 52 cases(54.17%)moderately differentiation,and 13 cases(13.54%)were poorly differentiation or un-differentiation.The levels of volume transport constant(K^(trans)),rate constant(K_(ep))and extravascular extracellular volume fraction(Ve)increased significantly in DCE-MRI examination,and the differences of them among different stages were significant(F=51.570,F=12.510,F=22.410,P<0.05).The total detection rate of DEC-MRI in diagnosing EC patients was 72.92%.The levels of uterine volume and tumor volume of different pathological grade increased significantly as the 3D-TVS examination,and the differences of them among different grading were significant(Z=-2.165,Z=-2.134,P<0.05),respectively.The total detection rate of 3D-TVS in diagnosing EC patients was 77.08%.The results of ROC curve analysis showed that the area under curve(AUC)of MRI and 3D-TVS respectively were 0.7

关 键 词：动态增强磁共振成像(DCE-MRI) 经阴道三维超声(3D-TVS)技术 子宫内膜癌 分期 诊断 

分 类 号：R737.33[医药卫生—肿瘤]