MRI不同序列在子宫内膜癌手术分期、肌层浸润诊断中的应用价值  

Application value of different MRI sequences in the diagnosis of surgical staging and muscular invasion of endometrial carcinoma

作　　者：冉琳 杨振 郭蓓 钟淑娟 RAN Lin;YANG Zhen;GUO Bei;ZHONG Shujuan(Pucheng County Hospital,Weinan 715500;Shaanxi Provincial People's Hospital,Xi'an 710068;Northwest Women's and Children's Hospital,Xi'an 710061,China)

机构地区：[1]蒲城县医院,陕西渭南715500 [2]陕西省人民医院,陕西西安710068 [3]西北妇女儿童医院,陕西西安710061

出　　处：《临床医学研究与实践》2022年第32期98-102,共5页Clinical Research and Practice

基　　金：陕西省卫生健康科研基金项目(No.2018D036)。

摘　　要：目的探究磁共振成像(MRI)不同序列在子宫内膜癌(EC)手术分期、肌层浸润诊断中的应用价值。方法选取蒲城县医院收治的180例EC患者作为研究对象,分别于术前使用T_(2)加权成像(T_(2)WI)、动态增强MRI(DCE-MRI)、扩散张量成像(DTI)对患者进行诊断。记录所有EC患者的手术病理检查结果,以手术病理检查结果为金标准,分析T_(2)WI、DCE-MRI、DTI、联合检测对EC患者手术分期的诊断符合率以及对肌层浸润、宫颈间质浸润诊断的灵敏度、特异度和准确度。结果联合检测对EC患者手术分期总体诊断符合率均明显高于T_(2)WI、DCE-MRI、DTI诊断(P<0.05);DTI对EC患者手术分期总体诊断符合率明显高于T_(2)WI、DCE-MRI诊断(P<0.05)。联合检测对EC患者肌层浸润的诊断准确度明显高于T_(2)WI、DCE-MRI、DTI诊断(P<0.05);DTI对EC患者肌层浸润的诊断准确度明显高于T_(2)WI诊断(P<0.05)。联合检测对EC患者宫颈间质浸润的诊断准确度明显高于T_(2)WI、DCE-MRI诊断(P<0.05);DTI对EC患者宫颈间质浸润的诊断准确度明显高于T_(2)WI、DCE-MRI诊断(P<0.05)。结论DTI对EC患者手术分期、肌层浸润、宫颈间质浸润的诊断价值高于T_(2)WI和DCE-MRI诊断,其中T_(2)WI、DTI联合DCE-MRI对EC的诊断价值最高,值得临床推广。Objective To explore the application value of different magnetic resonance imaging(MRI)sequences in the diagnosis of surgical staging and muscular invasion of endometrial carcinoma(EC).Methods A total of 180 patients with EC admitted in Pucheng County Hospital were selected as the study objects.T_(2) weighted imaging(T_(2)WI),dynamic contrast-enhanced MRI(DCE-MRI)and diffusion tensor imaging(DTI)were used to diagnose the patients before operation.The results of surgical pathological examination of all EC patients were recorded.Taking the results of surgical pathological examination as the gold standard,the diagnostic coincidence rate of T_(2)WI,DCE-MRI,DTI and combined detection for surgical staging of EC patients and the sensitivity,specificity and accuracy of diagnosis of muscular invasion and cervical stroma invasion were analyzed.Results The overall diagnostic coincidence rate of combined detection for surgical staging of EC patients was significantly higher than that of T_(2)WI,DCE-MRI and DTI(P<0.05);the overall diagnostic coincidence rate of DTI for surgical staging of EC patients was significantly higher than that of T_(2)WI and DCE-MRI(P<0.05).The diagnostic accuracy of combined detection for muscle invasion in EC patients was significantly higher than that of T_(2)WI,DCE-MRI and DTI(P<0.05);the diagnostic accuracy of DTI for muscular invasion in EC patients was significantly higher than that of T_(2)WI(P<0.05).The diagnostic accuracy of combined detection for cervical stroma invasion in EC patients was significantly higher than that of T_(2)WI and DCE-MRI(P<0.05);the diagnostic accuracy of DTI for cervical stroma invasion in EC patients was significantly higher than that of T_(2)WI and DCE-MRI(P<0.05).Conclusion The diagnostic value of DTI for surgical staging,muscular invasion and cervical stroma invasion of EC patients is higher than that of T_(2)WI and DCE-MRI.Among them,T_(2)WI,DTI combined with DCE-MRI has the highest diagnostic value for EC,which is worthy of clinical promotion.

关 键 词：子宫内膜癌 手术分期 肌层浸润 磁共振成像 动态增强MRI 扩散张量成像 

分 类 号：R737.33[医药卫生—肿瘤]