Jantarasaengaram S, Praditphol N, Tansathit T, Vipupinyo C, Vairojanavong K
Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
Ultrasound Obstet Gynecol. 2014 May;43(5):569-74. doi: 10.1002/uog.13200. Epub 2014 Apr 13.
To evaluate the accuracy of transvaginal three-dimensional ultrasound with volume contrast imaging (VCI) for preoperative assessment of depth of myometrial invasion and cervical involvement in women with endometrial cancer.
Transvaginal volume acquisition of the uterus was performed in 60 consecutive patients with histological diagnosis of endometrial cancer who were scheduled for primary surgical treatment. Depth of myometrial invasion and presence or absence of cervical involvement were assessed using VCI in multiplanar display mode. Results were compared to final postoperative histopathological findings. Patients with histological high-risk cell types, including Grade 3 endometrioid adenocarcinoma, clear cell carcinoma, papillary serous carcinoma and carcinosarcoma, were excluded.
Forty patients were included in the analysis. The accuracy of VCI in assessing single-stage myometrial invasion (superficial or deep) was 92.5%. In the prediction of deep myometrial invasion, sensitivity, specificity, PPV and NPV of VCI were 100%, 89.7%, 78.6% and 100%, respectively. The accuracy of VCI in assessing cervical involvement was 90.0%. Sensitivity, specificity, PPV and NPV of VCI in predicting the presence of cervical involvement were 100%, 86.2%, 73.3% and 100%, respectively.
Transvaginal VCI is an uncomplicated method that is able to predict with reasonable accuracy the depth of myometrial invasion and cervical involvement in women with endometrial cancer.
评估经阴道三维超声容积对比成像（VCI）在术前评估子宫内膜癌患者肌层浸润深度和宫颈受累情况方面的准确性。
对60例连续的经组织学诊断为子宫内膜癌且计划接受初次手术治疗的患者进行经阴道子宫容积采集。使用多平面显示模式下的VCI评估肌层浸润深度以及宫颈是否受累。将结果与术后最终组织病理学结果进行比较。排除组织学高危细胞类型的患者，包括3级子宫内膜样腺癌、透明细胞癌、乳头状浆液性癌和癌肉瘤。
40例患者纳入分析。VCI评估单阶段肌层浸润（浅表或深部）的准确性为92.5%。在预测深部肌层浸润方面，VCI的敏感性、特异性、阳性预测值和阴性预测值分别为100%、89.7%、78.6%和100%。VCI评估宫颈受累的准确性为90.0%。VCI预测宫颈受累的敏感性、特异性、阳性预测值和阴性预测值分别为100%、86.2%、73.3%和100%。
经阴道VCI是一种简单的方法，能够较为准确地预测子宫内膜癌患者的肌层浸润深度和宫颈受累情况。
