磁共振成像在早期子宫内膜癌术前分期诊断中的应用

摘要

Objective To investigate the value of magnetic resonance imaging (MRI) in preoperative staging of endometrial carcinoma of early stage.Methods MRI (T1WI, T2WI, DWI and gadolinium-enhanced T1 WI) examinations were performed before surgery in 144 patients with endometrial carcinoma of stage Ⅰto stage Ⅱ confirmed pathologically,the signal intensity and enhancement feature of tumors, the appearance of junctional zone, and the depth of myometrial invasion and cervical invasion were observed, and preoperative staging was performed.The results of preoperative staging were compared with postoperative pathological findings.Results Compared with normal endometria, the tumors were usually isointensity on T1WI and hyperintensity on T2 WI, DWI and gadolinium-enhanced T1 WI.The sensitivity, specificity and accuracy of DWI in assessing deep myometrial invasion were 85.19％ (23/27), 96.04％ (97/101) and 91.60％(120/131), respectively.The accuracy of MRI in assessing cervical invasion was 92.31％.Conclusion MRI is accurate and reliable in evaluation of myometrial invasion and cervical invasion of endometrial carcinoma, and may be performed as a routine preoperative examination.%目的 探讨磁共振成像(MRI)对早期子宫内膜癌术前分期的诊断价值.方法 对144例经分段诊刮病理学诊断证实的Ⅰ～Ⅱ期子宫内膜癌病例术前进行MRI(T<,1>WI、T<,2>WI、DWI和增强图像)检查,观察肿瘤信号、肿瘤范围、结合带显示情况和宫颈累及情况,判断深肌层浸润和宫颈浸润情况并进行术前分期;将术前分期结果 与手术-病理分期结果 进行比较.结果 与正常子宫内膜相比,肿瘤T<,1>WI多为等信号,T<,2>WI多为高信号,DWI为明显高信号,增强成像表现为肿瘤明显强化.MRI判断深肌层浸润的敏感度为85.19%(23/27),特异度为96.04%(97/101),诊断准确率为91.60%(120/131).MRI判断子宫内膜癌浸润宫颈的准确率为92.31%.结论 应用MRI评价子宫内膜癌肌层浸润深度、宫颈浸润情况较准确,可作为子宫内膜癌术前常规影像学检查.