摘要
目的探讨MRI对不同部位深部浸润型子宫内膜异位症(DIE)的诊断价值。资料与方法回顾性分析经手术病理证实的41例DIE患者,比较其术前MRI诊断与腹腔镜手术病理结果,评价MRI对不同部位DIE的诊断效能。结果41例患者中,MRI诊断直肠阴道隔DIE的敏感度、特异度及准确度分别为88.9%(24/27)、71.4%(10/14)及82.9%(34/41),诊断子宫骶骨韧带DIE的敏感度、特异度及准确度分别为83.0%(44/53)、72.4%(21/29)及79.3%(65/82),诊断子宫直肠凹粘连、封闭的敏感度、特异度及准确度分别为94.1%(32/34)、71.4%(5/7)及90.2%(37/41),诊断膀胱DIE的敏感度、特异度及准确度分别为50.0%(2/4)、100.0%(37/37)及95.1%(39/41),诊断直肠DIE的敏感度、特异度及准确度分别为20.0%(1/5)、91.7%(33/36)及82.9%(34/41)。其中MRI诊断子宫直肠凹粘连、封闭的敏感度最高,诊断膀胱DIE的特异度最高。MRI对发现直肠DIE病灶有一定的局限性。结论MRI在诊断多个部位DIE受累方面有较高的准确度,可预测DIE所致子宫直肠凹粘连、封闭,对于直肠阴道隔DIE、子宫骶骨韧带受累也有较好的诊断价值。MRI可以在术前对DIE病灶进行准确的解剖定位及评估受累范围,为临床提供更多的信息,更好地协助精准治疗。
Purpose To explore the clinical value of MRI in the identification of different locations in deep infiltrating endometriosis(DIE)Materials and Methods Forty-one patients with histologically confirmed DIE were retrospectively studied.All the patients underwent MRI before laparoscopic surgery.Mapping of different locations in DIE was performed.MRI results were compared with surgical and pathological findings,and the diagnostic efficacy of different locations in DIE was evaluated.Results Among 41 patients,the sensitivity,and accuracy for MRI in the detection of DIE in retrocervical septum were 88.9%(24/27),71.4%(10/14)and 82.9%(34/41),respectively;those for DIE in uterosacral ligament were 83.0%(44/53),72.4%(21/29)and 79.3%(65/82),respectively;those for posterior cul-de-sac obliteration and adhesion were 94.1%(32/34),71.4%(5/7)and 90.2%(37/41),respectively;those for bladder DIE were 50.0%(2/4),100%(37/37)and 95.1%(39/41),respectively;and those for rectum DIE were 20.0%(1/5),91.7%(33/36)and 82.9%(34/41),respectively.MRI showed the highest sensitivity in cul-de-sac obliteration and adhesion,and the highest specificity in bladder DIE.There were limitations in detecting rectum DIE lesions.Conclusion MRI can demonstrate a high accuracy in the diagnosis of multiple locations of DIE,especially in the detection of cul-de-sac obliteration,assessing the diagnosis value of DIE inretrocervical septum and uterosacral ligament,as well as evaluation the locations and extension of DIE before surgery.The information offered by MRI is very helpful in determining surgical options and planning appropriate treatment.
作者
王曼頔
孙孟言
李斌
郝坤
陆菁菁
戴毅
冷金花
WANG Mandi;SUN Mengyan;LI Bin;HAO Kun;LU Jingjing;DAI Yi;LENG Jinhua(Department of Radiology,Chinese Academy of Medical Sciences&Peking Union Medical College Hospital,Beijing 100730,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2019年第9期703-708,共6页
Chinese Journal of Medical Imaging
关键词
子宫内膜异位症
磁共振成像
敏感性与特异性
病理学
外科
Endometriosis
Magnetic resonance imaging
Sensitivity and specificity
Pathology,surgical
