| 刘明明,梁宇霆,张紫欣,张艺,关伟.MRI术前诊断子宫内膜癌宫颈间质浸润[J].中国医学影像技术,2016,32(1):95~98 |
| MRI术前诊断子宫内膜癌宫颈间质浸润 |
| Preoperative MRI in detecting of cervical stromal infiltration of endometrial carcinoma |
| 投稿时间：2015-03-12 修订日期：2015-06-16 |
| DOI：10.13929/j.1003-3289.2016.01.025 |
| 中文关键词: 子宫内膜肿瘤 宫颈间质浸润 磁共振成像 |
| 英文关键词:Endometrial neoplasms Cervical stromal infiltration Magnetic resonance imaging |
| 基金项目: |
|
| 摘要点击次数: 2605 |
| 全文下载次数: 843 |
| 中文摘要: |
| 目的 探讨MRI术前诊断Ⅱ期子宫内膜癌宫颈间质浸润的价值及MR动态增强扫描在定位宫颈内口中的意义。方法 回顾性分析经手术病理证实的107例子宫内膜癌患者资料。以手术后病理分期为金标准,采用Fisher's确切概率法分别评价术前MRI和分段诊断性刮宫对Ⅱ期、>Ⅱ~Ⅳ期子宫内膜癌宫颈间质浸润的诊断效能,分析MRI和分段诊刮诊断对Ⅱ期子宫内膜癌宫颈间质浸润的敏感度、特异度、准确率、阳性预测值和阴性预测值。观察动脉期宫体肌层与宫颈肌层强化特点。结果 MRI和分段诊刮对Ⅱ期内膜癌宫颈间质浸润的诊断效能差异有统计学意义(P=0.03),对>Ⅱ~Ⅳ期差异无统计学意义(P=0.36);MRI术前诊断Ⅱ期子宫内膜癌宫颈间质浸润的敏感度、特异度、准确率、阳性预测值和阴性预测值为56.25%(9/16)、97.80%(89/91)、91.59%(98/107)、81.81%(9/11)、92.71%(89/96)。宫体肌层与宫颈肌层在动脉期形成清晰的分界面。结论 MRI术前评估Ⅱ期子宫内膜癌宫颈间质有较大价值,优于分段诊断性刮宫。在动态增强扫描动脉期,宫体肌层与宫颈肌层强化差异形成的分界面有助于宫颈内口的定位,有助于MRI发现宫颈间质浸润。 |
| 英文摘要: |
| Objective To explore the diagnostic value of MRI in detecting cervical stromal infiltration of stage Ⅱ endometrial carcinoma, and the value of dynamic contrast-enhanced imaging in locating the internal cervical os. Methods All 107 cases of endometrial carcinoma confirmed by pathology were retrospectively analyzed. The efficiency for evaluation of cervical stromal infiltration (stageⅡ, stage>Ⅱ-Ⅳ) was compared between the two ways using Fisher's exact test. The sensitivity, specificity, accuracy of MRI and fractional curettage in diagnosing stage Ⅱ endometrial carcinoma was assessed. The enhancement characteristics of uterine body and cervix at arterial phase were observed. Results The diagnosing efficacy was statistical different between MRI and fractional curettage in stage Ⅱ cases (P=0.03), but there was no statistical different in stage >Ⅱ-Ⅳ cases (P=0.36). In stage Ⅱ, the sensitivity, specificity, accuracy, positive and negative predictive values of MRI were 56.25% (9/16), 97.80% (89/91), 91.59% (98/107), 81.81% (9/11), 92.71% (89/96), respectively. At arterial phase, the degrees of enhancement of uterine body and cervix were markedly different, and there was clear interface between them. Conclusion For evaluating cervical stromal infiltration of stage Ⅱ endometrial carcinoma, the diagnostic efficiency of MRI is more valuable and better than that of fractional curettage. At arterial phase, the varying degrees of enhancement and the resulting interface between uterine body and cervix contribute to locating of internal cervical os and detecting of cervical stromal infiltration on MRI. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
