摘要
目的:对比MR动态增强(DCE)和扩散加权成像(DWI)评估子宫内膜癌宫颈间质浸润的价值。方法:回顾性分析2009年2月-2017年2月天津医科大学总医院手术确诊为子宫内膜癌的250例患者的术前盆腔MRI资料,由两位医师分别在DWI联合T2WI、DCE联合T2WI序列下评估是否存在宫颈间质浸润,计算并对比两种序列评估宫颈间质浸润的符合率、敏感度、特异度、阳性预测值和阴性预测值,同时分析影响不同序列判断子宫内膜癌宫颈间质浸润的因素。结果:医师1采用DCE+T2WI和DWI+T2WI判断宫颈间质浸润的符合率、敏感度、特异度、阳性预测值和阴性预测值分别为98.4%、96.3%、98.7%、90.0%、99.6%和95.2%、92.6%、95.5%、71.4%、99.1%;医师2采用DCE+T2WI和DWI+T2WI判断宫颈间质浸润的符合率、敏感度、特异度、阳性预测值和阴性预测值分别为94.0%、88.9%、94.6%、66.7%、98.6%和88.4%、74.1%、90.1%、47.6%、96.6%。DCE联合T2WI序列判断宫颈间质浸润的符合率高于DWI。子宫峡部受累是影响DWI判断宫颈间质浸润的主要因素。结论:MR动态增强联合常规T2WI序列对于判断子宫内膜癌宫颈间质浸润优于扩散加权成像。
Objective:To compare the diagnostic value of MR dynamic contrast enhanced(DCE)imaging with diffusion weighted imaging(DWI)in the evaluation of the cervical stromal infiltration in the context of endometrial cancer.Methods:250 patients who were diagnosed with endometrial cancer pathologically from February 2009 to February 2017 were enrolled into this retrospective study.The preoperative MRI images of all patients were collected and analyzed.Two radiologists independently identified whether there was cervical stromal infiltration on DWI and/or DCE imaging combined with T2-weighted imaging.The differences of diagnostic accuracy,sensitivity,specificity,positive predictive value and the negative predictive value were calculated and compared.The factors that impacted the performances of different imaging sequences were also recorded.Results:The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of DCE+T2WI and DWI+T2WI in evaluating the cervical stromal infiltration were 98.4%,96.3%,98.7%,90.0%,99.6%and 95.2%,92.6%,95.5%,71.4%,99.1%for reader 1,and that for reader 2 were 94.0%,88.9%,94.6%,66.7%,98.6%and 88.4%,74.1%,90.1%,47.6%,96.6%,respectively.The combination of DCE and T2WI sequence outperformed DWI combined with T2WI in diagnostic accuracy for cervical stromal infiltration,with the involvement of uterine isthmus being the unique factor that significantly influenced the assessment.Conclusion:Dynamic contrast enhanced(DCE)MR imaging combined with regular T2WI has a better performance in determining the cervical stromal invasion in endometrial cancer than DWI+T2WI.
作者
崔建民
孙浩然
CUI Jian-min;SUN Hao-ran(Department of Radiology,Tianjin First Central Hospital,Tianjin 300192,China)
出处
《放射学实践》
北大核心
2020年第11期1441-1446,共6页
Radiologic Practice
关键词
子宫内膜肿瘤
磁共振成像
宫颈间质浸润
动态对比增强
扩散加权成像
Endometrial neoplasms
Magnetic resonance imaging
Cervical stromal infiltration
Dynamic contrast enhanced
Diffusion weighted imaging
