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目的 :探讨3.0TMR动态增强扫描(DCE-MRI)联合扩散加权成像(DWI)在评估诊断子宫内膜癌患者肌层浸润深度、宫颈侵犯和术前分期中的应用价值。方法:经病理证实的26例子宫内膜癌患者术前MRI影像资料,包括T_1WI、T_2WI、DCE-MRI和DWI序列,对照术后病理结果,评估应用DCE-MRI、DWI及DCE-MRI联合DWI法诊断子宫内膜癌肌层浸润、宫颈侵犯和术前分期的敏感性、特异性、准确率、阳性预测值、阴性预测值;比较不同成像方法对肌层浸润、宫颈侵犯和术前分期的准确率。结果:DCE-MRI、DWI及DCE-MRI联合DWI法判断肌层浸润深度的准确率分别为76.92%、73.08%和84.62%,DCE-MRI联合DWI法高于单独应用DCE-MRI和单独应用DWI法,差异具有统计学意义(P<0.05);DCE-MRI、DWI及DCE-MRI联合DWI法判断宫颈侵犯的准确率分别为76.92%、73.08%和88.46%,DCE-MRI联合DWI法高于单独应用DCE-MRI和单独应用DWI法,差异具有统计学意义(P<0.05);DCE-MRI、DWI及DCE-MRI联合DWI法判断分期的准确率分别为65.38%、53.85%和80.77%,DCEMRI联合DWI法高于单独应用DCE-MRI和单独应用DWI法,差异具有统计学意义(P<0.05)。结论 :联合应用DCE-MRI和DWI较单独应用DCE-MRI或DWI可以更准确地进行子宫内膜癌术前评估,应常规应用于子宫内膜癌的术前检查。
Objective: To investigate the value of 3.0T MR dynamic contrast-enhanced scanning (DCE-MRI) combined with diffusion-weighted imaging (DWI) in the evaluation of myometrial invasion, cervical invasion and preoperative staging in patients with endometrial cancer. Methods: Twenty-six patients with endometrial carcinoma confirmed by pathology underwent preoperative MRI, including T_1WI, T_2WI, DCE-MRI and DWI. The postoperative pathological results were compared and evaluated by DCE-MRI, DWI and DCE-MRI combined with DWI The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the diagnosis of endometrial carcinoma in patients with myometrial invasion, cervical invasion and preoperative staging were compared. The different imaging methods were compared for the invasion of myometrial invasion, cervical invasion and preoperative staging Accuracy. Results: The accuracy of DCE-MRI, DWI and DCE-MRI combined with DWI in determining myometrial invasion depth was 76.92%, 73.08% and 84.62%, respectively. DCE-MRI combined with DWI was superior to DCE-MRI alone and DWI alone MRI, DWI and DCE-MRI combined with DWI were 76.92%, 73.08% and 88.46%, respectively. The accuracy of DCE-MRI combined with DWI was higher than that of DCE-MRI combined with DWI The accuracy of DCE-MRI, DWI and DCE-MRI in combination with DWI was 65.38%, 53.85% and 80.77%, respectively, with DCE-MRI alone and DWI alone. DCEMRI combined DWI method higher than the single application of DCE-MRI and DWI alone, the difference was statistically significant (P <0.05). Conclusion: DCE-MRI and DWI combined with DCE-MRI or DWI alone can evaluate the preoperative evaluation of endometrial cancer more accurately and should be routinely applied to the preoperative examination of endometrial cancer.