1.5T 磁共振成像在子宫内膜癌中的应用。

Application of 1.5 T magnetic resonance imaging in endometrial cancer.

机构信息

Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.

出版信息

Arch Gynecol Obstet. 2012 Apr;285(4):1113-8. doi: 10.1007/s00404-011-2053-0. Epub 2011 Sep 7.

DOI:10.1007/s00404-011-2053-0

PMID:21898079

Abstract

OBJECTIVE

To determine the diagnostic accuracy, sensitivity and specificity of magnetic resonance imaging (MRI) in detecting myometrial invasion, cervical involvement and disease stage in endometrial cancer.

METHODS

168 consecutive patients with endometrial carcinoma underwent preoperative MRI. We classified myometrial invasion as no invasion, ≤50% invasion or >50% invasion and cervical involvement as positive or negative. The preoperative MRI findings and stagings were compared with final surgical and histological staging; the latter was taken as the gold standard. Standard statistical calculations were used.

RESULTS

The sensitivity, specificity, and accuracy of MRI for the detection of myometrial invasion >50% were 64.7, 92.5, and 86.9%, respectively. Positive and negative predictive values were 68.8 and 91.2%, respectively. The sensitivity, specificity, and accuracy of MRI for the detection of cervical invasion were 52.63, 93.08, and 83.93%, respectively. Positive and negative predictive values were 68.97 and 87.05%, respectively. 102 cases were classified as stage IA (early disease) by histology. MRI accurately predicted the degree of invasion in 88 cases and overestimated in 14, giving a sensitivity of 86.3% and specificity of 69.1%. However, MRI showed reduced sensitivity for predicting stage IB and advanced endometrial cancer (stages III and IV) at 33.3 and 30.3%, respectively, but was found to be specific for predicting these stages; the specificity were 94.7 and 85.1%, respectively. MRI also showed good accuracy for predicting stage IA, IB, II and advanced endometrial cancer at 80.4, 86.9, 91.7, and 83.9, respectively.

CONCLUSION

MRI assists in planning the surgical treatment of endometrial cancer with good accuracy and specificity, although sensitivity is suboptimal.

摘要

目的

评估磁共振成像（MRI）在检测子宫内膜癌肌层浸润、宫颈受累和疾病分期方面的诊断准确性、敏感度和特异度。

方法

168 例连续的子宫内膜癌患者接受了术前 MRI 检查。我们将肌层浸润分为无浸润、≤50%浸润和>50%浸润，宫颈受累分为阳性或阴性。将术前 MRI 检查结果和分期与最终的手术和组织学分期进行比较，后者作为金标准。采用标准的统计计算方法。

结果

MRI 检测>50%肌层浸润的敏感度、特异度和准确度分别为 64.7%、92.5%和 86.9%。阳性和阴性预测值分别为 68.8%和 91.2%。MRI 检测宫颈受累的敏感度、特异度和准确度分别为 52.63%、93.08%和 83.93%。阳性和阴性预测值分别为 68.97%和 87.05%。102 例患者组织学上被归类为 IA 期（早期疾病）。MRI 准确预测了 88 例患者的浸润程度，高估了 14 例，其敏感度为 86.3%，特异度为 69.1%。然而，MRI 对预测 IB 期和晚期子宫内膜癌（III 期和 IV 期）的敏感度分别为 33.3%和 30.3%，但对这些分期的特异性较高，分别为 94.7%和 85.1%。MRI 对预测 IA、IB、II 和晚期子宫内膜癌的分期准确度分别为 80.4%、86.9%、91.7%和 83.9%。