MRI动态增强扫描在子宫内膜癌术前诊断中的应用

【】目的探讨MRI动态增强扫描在子宫内膜癌手术前诊断中的价值。方法回顾分析2008年2月-2010年3月38例经手术病理证实为子宫内膜癌患者的动态增强MRI检查资料，判断内膜癌子宫肌层和宫颈浸润情况，与病理结果对照，计算T2WI及动态增强序列诊断肌层及宫颈浸润的敏感度、特异度、准确度等，分析两种序列诊断准确度有无差异；计算内膜癌组织与子宫肌层在动态增强各期的对比信噪比，并分析其在各期间有无差异。结果动态增强序列诊断内膜癌肌层和宫颈受侵的敏感度、特异度、阳性预测值、阴性预测值分别为96.8%、85.7%、96.8%、85.7%和85.7%、91.7%、85.7%、91.7%；动态增强序列诊断内膜癌深肌层浸润的准确度为94.7%，显著高于T2WI诊断深肌层浸润的准确度78.9%（P<0.05）；平衡期内膜癌组织与子宫肌层的对比信噪比显著高于动脉期和静脉期（P<0.01）。结论MRI动态增强扫描能够在手术前准确的判断内膜癌肌层及宫颈浸润，有助于子宫内膜癌治疗方式的选择。？【Abstract】ObjectiveToinvestigatetheroleofdynamic-enhancedMRIinthediagnosisofendometrialcarcinoma.MethodsThirty-eightpatientswithendometrialcarcinomaconfirmedbysurgicopathologyundergonedynamic-enhancedMRIscanswereanalyzedretrospectively.Theinvasioninmyometriumanduterinecervixwereanalyzed.Thetumorandmyometriumcontrast-to-noiseratiosduringdifferentphasesofdynamicimagingwerecalculated.MRimagingfindingswerecomparedwithpathologicfindings.Sensitivity,specificity,diagnosticaccuracy,positiveandnegativepredictivevaluesofMRimagingindepictingmyometrialandcervicalinfiltrationwerecalculated.ResultsRespectivesensitivity,specificity,andpositiveandnegativepredictivevaluesinassessingmyometrialinfiltrationwere96？8%,85.7%,96.8%,85.7%;thoseforcervicalinfiltrationwere85.7%,91.7%,85.7%,91.7%,respectively.Thediagnosticaccuracy(94.7%)ofdynamicimagingindepictingdeepmyometrialinfiltrationweresignificantlyhigherthanthatofT2WI(78.9%)(P<0.05).Therewasasignificantimprovementintumorandmyometriumcontrast-to-noiseratiosduringtheequilibriumphasecomparedwiththearterialandvenousphases(P<0.01).ConclusionDynamic-enhancedMRIishighlyaccurateinpreoperativediagnosisofendometrialcarcinoma,whichwillbenefitforthetreatofendometrialcarcinoma.