MRI不同序列组合评估子宫内膜癌宫颈间质浸润及术前分期的对比研究  

Comparative Study of Different Sequence Combinations of MRI in Evaluating Cervical Stromal Infiltration and Preoperative Staging of Endometrial Carcinoma

作　　者：陈丽娟[1] 潘自来[1] 徐敬慈[1] 邵丹丹[1] 苏文婷[1] CHEN Lijuan;PAN Zilai;XU Jingci;SHAO Dandan;SU Wenting(Department of Radiology,RuiJin Hospital North,Shanghai Jiao Tong University School of Medicine)

机构地区：[1]上海交通大学医学院附属瑞金医院北部院区放射科

出　　处：《中国医学计算机成像杂志》2022年第2期152-156,共5页Chinese Computed Medical Imaging

摘　　要：目的:比较MRI不同序列组合评估子宫内膜癌宫颈间质浸润及术前分期的准确性。方法:选取128例经病理证实的子宫内膜癌患者的术前MRI,包括:T2WI、T1WI、DWI及DCE-MRI序列,不同序列组合对子宫内膜癌宫颈间质浸润、术前分期进行评估,与术后病理结果对照,计算子宫内膜癌宫颈间质浸润的灵敏度、特异度、阳性预测值、阴性预测值和准确度,并采用配对卡方检验比较不同序列组合对宫颈间质浸润及术前分期评估的准确度。结果:常规T2WI+T1WI诊断子宫内膜癌宫颈间质浸润的准确度为88.3%,DCE+T2WI为97.7%,DWI+T2WI为95.3%,DCE+T2WI诊断宫颈间质浸润的准确度要高于DWI+T2WI和T2WI+T1WI,其中DCE+T2WI与T2WI+T1WI之间差异具有统计学意义。T2WI+T1WI判断子宫内膜癌术前分期准确度为78.1%,DCE+T2WI为91.4%,DWI+T2WI为93.8%,DWI+T2WI与DCE+T2WI评估子宫内膜癌分期的准确度要明显高于T2WI+T1WI,差异具有统计学意义。结论:DWI+T2WI与DCE+T2WI评估子宫内膜癌宫颈间质浸润及术前分期具有相当的准确度,诊断效能均优于T2WI+T1WI。Purpose:To compare the accuracy of different sequence combinations of MRI in evaluating cervical stromal invasion and preoperative staging of endometrial carcinoma.Methods:One hundred and twenty-eight patients with histopathologically proven endometrial carcinoma were undergone preoperative MRI before total hysterectomy.The MR protocol included T2WI,T1WI,DCE and DWI.The MRI findings were compared with postoperative histopathological findings,and the latter was taken as the golden standard.Software(SPSS 17.0 for Windows)was used for analysis.The sensitivity,specificity,positive and negative predictive values and diagnostic accuracy of different sequence combination in depicting cervical stromal infiltration and preoperative staging were calculated.The accuracy of the evaluation of the cervical stromal infiltration and stage was compared among different sequence combination using paired Chi-square test.Results:The diagnostic accuracy for the identification of cervical stromal infiltration were 88.3%on T2WI+T1WI,97.7%on DCE+T2WI and 95.3%on DWI+T2WI,and there was statistical difference of accuracy between T2WI+T1WI and DCE+T2WI.For overall stages,the accuracy of T2WI+T1WI,DCE+T2WI,and DWI+T2WI was 78.1%,91.4%,93.8%,respectively;the accuracy of DWI+T2WI and DCE+T2WI in evaluating endometrial cancer stage was higher than that of T2WI+T1WI,with statistically significant difference.Conclusion:DWI+T2WI and DCE+T2WI have comparable accuracy in the evaluation of cervical interstitial infiltration and preoperative staging of endometrial cancer,and their diagnostic efficacy is superior to T2WI+T1WI.

关 键 词：子宫内膜癌 分期 磁共振成像 弥散加权成像 动态对比增强 

分 类 号：R445.2[医药卫生—影像医学与核医学]