Zandrino Franco, La Paglia Ernesto, Musante Francesco
Department of Radiology, Azienda Ospedaliera 55 Antonio e Biagio e C. Arrigo, Alessandria, Italy.
Tumori. 2010 Jul-Aug;96(4):601-8. doi: 10.1177/030089161009600414.
To assess the diagnostic accuracy of magnetic resonance imaging in local staging of endometrial carcinoma, and to review the results and pitfalls described in the literature.
Thirty women with a histological diagnosis of endometrial carcinoma underwent magnetic resonance imaging. Unenhanced T2-weighted and dynamic contrast-enhanced Ti-weighted sequences were obtained. Hysterectomy and salpingo-oophorectomy was performed in all patients. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for the detection of deep myometrial and cervical infiltration.
For deep myometrial infiltration T2-weighted sequences reached a sensitivity of 85%, specificity of 76%, PPV of 73%, NVP of 87%, and accuracy of 80%, while contrast-enhanced scans reached a sensitivity of 90%, specificity of 80%, PPV of 82%, NPV of 89%, and accuracy of 85%. For cervical infiltration T2-weighted sequences reached a sensitivity of 75%, specificity of 88%, PPV of 50%, NPV of 96%, and accuracy of 87%, while contrast-enhanced scans reached a sensitivity of 100%, specificity of 94%, PPV of 75%, NPV of 100%, and accuracy of 95%.
Unenhanced and dynamic gadolinium-enhanced magnetic resonance allows accurate assessment of myometrial and cervical infiltration. Information provided by magnetic resonance imaging can define prognosis and management.
评估磁共振成像在子宫内膜癌局部分期中的诊断准确性，并回顾文献中描述的结果及陷阱。
30例经组织学诊断为子宫内膜癌的女性接受了磁共振成像检查。获取了未增强的T2加权序列和动态对比增强的T1加权序列。所有患者均接受了子宫切除术和输卵管卵巢切除术。计算检测肌层深部浸润和宫颈浸润的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）及准确性。
对于肌层深部浸润，T2加权序列的敏感性为85%，特异性为76%，PPV为73%，NVP为87%，准确性为80%；而对比增强扫描的敏感性为90%，特异性为80%，PPV为82%，NPV为89%，准确性为85%。对于宫颈浸润，T2加权序列的敏感性为75%，特异性为88%，PPV为50%，NPV为96%，准确性为87%；而对比增强扫描的敏感性为100%，特异性为94%，PPV为75%，NPV为100%，准确性为95%。
未增强及动态钆增强磁共振成像能够准确评估肌层和宫颈浸润情况。磁共振成像提供的信息可用于明确预后及指导治疗。
