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目的探讨磁共振成像在子宫内膜癌术前评估中的临床应用价值。方法回顾性收集94例经手术病理证实的子宫内膜癌患者,将术前磁共振成像检查结果与手术病理结果对照,评价T2加权像(T2WI)结合增强扫描或弥散加权成像(DWI)判断子宫内膜癌肌层浸润深度及淋巴结转移的价值。结果 94例子宫内膜癌中,无或浅肌层浸润的子宫内膜癌62例、深肌层浸润的子宫内膜癌32例;24组转移性淋巴结、164组非转移性淋巴结。T2WI结合增强扫描或DWI鉴别无/浅肌层浸润和深肌层浸润的准确率、特异性、敏感性、阴性及阳性预测值分别为88.3%、90.3%、84.4%、91.8%、81.8%和81.9%、87.1%、71.9%、85.7%、74.2%。T2WI结合增强扫描、DWI判断淋巴结转移的准确率、特异性、敏感性、阴性及阳性预测值分别为89.4%、96.8%、54.5%、90.9%、78.3%和91.5%、95.5%、72.7%、94.3%、77.4%。结论磁共振成像T2WI结合增强扫描判断子宫内膜癌肌层浸润深度的能力优于T2WI结合DWI,DWI鉴别淋巴结转移较T2WI结合增强扫描更敏感。
Objective To investigate the clinical value of magnetic resonance imaging in the preoperative evaluation of endometrial carcinoma. Methods Ninety-four patients with pathologically confirmed endometrial cancer were retrospectively studied. The results of preoperative MRI and surgical pathology were compared to evaluate the value of T2 weighted imaging (T2WI) in combination with contrast-enhanced imaging or diffusion-weighted imaging (DWI) The value of intimal cancer invasion and lymph node metastasis. Results In 94 cases of endometrial carcinoma, 62 cases of endometrial carcinoma without superficial myometrial invasion, 32 cases of deep myometrial infiltration of endometrial carcinoma, 24 metastatic lymph nodes and 164 non-metastatic lymph nodes. The accuracy, specificity, sensitivity, negative and positive predictive value of T2WI in combination with contrast-enhanced scan or DWI in differentiating non-superficial myometrial invasion and deep muscular invasion were 88.3%, 90.3%, 84.4%, 91.8%, 81.8% and 81.9%, 87.1%, 71.9%, 85.7%, 74.2%. The accuracy, specificity, sensitivity, negative and positive predictive value of T2WI combined with enhanced scan and DWI in determining lymph node metastasis were 89.4%, 96.8%, 54.5%, 90.9%, 78.3% and 91.5%, 95.5%, 72.7% 94.3%, 77.4%. Conclusions MRI T2WI combined with enhanced MRI is superior to T2WI combined with DWI in determining the depth of myometrial invasion, and DWI is more sensitive than T2WI in enhancing contrast-enhanced scanning.