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磁共振成像在子宫内膜癌术前分期中的应用

Magnetic resonance imaging in the preoperative staging of endometrial carcinoma.

作者信息

Cabrita S, Rodrigues H, Abreu R, Martins M, Teixeira L, Marques C, Mota F, de Oliveira C Freire

机构信息

Department of Gynecology, University Hospital of Coimbra, Portugal.

出版信息

Eur J Gynaecol Oncol. 2008;29(2):135-7.

Abstract

PURPOSE OF INVESTIGATION

Magnetic resonance imaging (MRI) has emerged as an important imaging modality in the evaluation of the extension of endometrial carcinoma which is essential in planning treatment and predicting prognosis. This study aimed to assess the value of MRI in the preoperative staging of endometrial carcinoma.

METHODS

We included in this study 162 patients with a histological diagnosis of endometrial carcinoma who underwent MRI pelvic imaging and surgical staging. MRI images were compared with pathological findings to measure MRI's sensitivity, specificity, positive and negative predictive values and diagnostic accuracy in what concerns myometrial, cervical and lymph node invasion.

RESULTS

MRI differentiation of deep myometrial invasion from superficial disease agreed with pathological findings in 77% of cases, with a sensitivity of 83%, a specificity of 72% and a diagnostic accuracy of 77%. Concerning cervical invasion, MRI had a sensitivity, specificity and diagnostic accuracy of 42%, 92%, 81% respectively. In assessing lymph node invasion, MRI presented a sensitivity of just 17%, a specificity of 99% and a diagnostic accuracy of 89%.

CONCLUSION

Our study confirmed the high accuracy of MRI imaging in assessing myometrial and cervical invasion in endometrial carcinoma. When evaluating lymph node invasion, micrometastases are responsible for the low sensitivy of MRI.

摘要

研究目的

磁共振成像(MRI)已成为评估子宫内膜癌浸润范围的一种重要成像方式,这对于制定治疗方案和预测预后至关重要。本研究旨在评估MRI在子宫内膜癌术前分期中的价值。

方法

本研究纳入了162例经组织学诊断为子宫内膜癌的患者,这些患者均接受了盆腔MRI成像及手术分期。将MRI图像与病理结果进行比较,以测量MRI在子宫肌层、宫颈及淋巴结浸润方面的敏感性、特异性、阳性和阴性预测值以及诊断准确性。

结果

MRI对子宫肌层深部浸润与浅表病变的鉴别与病理结果相符的病例占77%,敏感性为83%,特异性为72%,诊断准确性为77%。对于宫颈浸润,MRI的敏感性、特异性和诊断准确性分别为42%、92%、81%。在评估淋巴结浸润时,MRI的敏感性仅为17%,特异性为99%,诊断准确性为89%。

结论

我们的研究证实了MRI成像在评估子宫内膜癌子宫肌层和宫颈浸润方面具有较高的准确性。在评估淋巴结浸润时,微转移是导致MRI敏感性较低的原因。

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