Sezione di Scienze Radiologiche del Dipartimento Materno Infantile e Scienze Radiologiche, Università degli Studi di Catania, Catania, Italy.
Radiol Med. 2013 Apr;118(3):487-503. doi: 10.1007/s11547-012-0861-3. Epub 2012 Aug 8.
This study was undertaken to prospectively determine the diagnostic capabilities of magnetic resonance (MR) imaging in detecting myometrial and cervical invasion and lymph node involvement in endometrial carcinoma and to identify the causes of errors in staging endometrial carcinoma.
Twenty consecutive patients with a histological diagnosis of endometrial carcinoma underwent preoperative MR imaging. MR findings were compared with surgical staging, considered as the standard of reference.
In assessing myometrial invasion, MR imaging showed 70% accuracy, 80% sensitivity, 40% specificity, 80% positive predictive value (PPV), and 40% negative predictive value (NPV). In detecting cervical invasion, MR imaging had 95% accuracy, 100% sensitivity, 94.4% specificity, 66.7% PPV, and 100% NPV. In evaluating lymph node involvement, MR imaging showed 100% accuracy, sensitivity, specificity, PPV and NPV. Errors in evaluating myometrial invasion were caused by polypoid tumour, adenomyosis and leiomyomas, whereas those in evaluating cervical invasion were caused by dilatation and curettage.
MR imaging is a reliable technique for preoperative evaluation of endometrial carcinoma. Its main limitation is differentiating between stage IA and IB carcinomas, which is not highly important for surgical planning. Cooperation between the gynaecologist and radiologist is mandatory to avoid staging errors.
本研究旨在前瞻性评估磁共振成像（MR）在检测子宫内膜癌肌层和宫颈浸润及淋巴结转移方面的诊断能力，并确定子宫内膜癌分期错误的原因。
连续 20 例经组织学诊断为子宫内膜癌的患者接受了术前 MR 成像检查。将 MR 结果与手术分期进行比较，后者被视为参考标准。
在评估肌层浸润方面，MR 成像的准确性为 70%，敏感性为 80%，特异性为 40%，阳性预测值（PPV）为 80%，阴性预测值（NPV）为 40%。在检测宫颈浸润方面，MR 成像的准确性为 95%，敏感性为 100%，特异性为 94.4%，PPV 为 66.7%，NPV 为 100%。在评估淋巴结转移方面，MR 成像的准确性、敏感性、特异性、PPV 和 NPV 均为 100%。评估肌层浸润时的错误是由息肉样肿瘤、子宫腺肌病和平滑肌瘤引起的，而评估宫颈浸润时的错误是由扩张和刮宫引起的。
MR 成像技术是术前评估子宫内膜癌的可靠方法。其主要局限性是难以区分 IA 期和 IB 期癌，这对手术计划并不重要。妇科医生和放射科医生之间的合作是必不可少的，以避免分期错误。
