Department of Women's and Children's health, Karolinska University Hospital, 171 76 Stockholm, Sweden.
Department of Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden.
Best Pract Res Clin Obstet Gynaecol. 2014 Jul;28(5):721-39. doi: 10.1016/j.bpobgyn.2014.04.007. Epub 2014 Apr 30.
The prognosis for women with endometrial cancer is generally good. This is because the disease is often diagnosed at an early treatable stage, as women seek care owing to postmenopausal bleeding. The prognosis is, however, worse for women with high-risk endometrial cancer. These women may benefit from more extensive surgery, including pelvic- and para-aortic lymph-node dissection, whereas such surgery is of no benefit for women with low-risk cancer. It is, therefore, important to correctly identify women with high-risk cancer before surgery. No consensus has been reached on how and when to use imaging to assess local extension of the disease. Nevertheless, evidence shows that imaging will improve the identification of women with high-risk cancer. The primary aim of this review is to present the examination technique, accuracy, imaging findings, benefits, and shortcomings of ultrasound and magnetic resonance imaging in the assessment of local tumour extension, in women with endometrial cancer. A secondary goal is to discuss the role of positron emission tomography and computed tomography, diagnostic modalities that primarily are used to detect lymph node and distant metastasis.
子宫内膜癌患者的预后通常较好。这是因为这种疾病通常在早期可治疗的阶段被诊断出来，因为女性会因为绝经后出血而寻求治疗。然而，高危子宫内膜癌患者的预后较差。这些女性可能受益于更广泛的手术，包括盆腔和主动脉旁淋巴结清扫术，而对于低危癌症患者，这种手术则没有益处。因此，在手术前正确识别高危癌症患者非常重要。目前尚无关于如何以及何时使用影像学评估疾病局部扩展的共识。尽管如此，有证据表明影像学检查将提高高危癌症患者的识别率。本综述的主要目的是介绍超声和磁共振成像在评估子宫内膜癌患者局部肿瘤扩展方面的检查技术、准确性、影像学表现、获益和不足。次要目标是讨论正电子发射断层扫描和计算机断层扫描的作用，这些诊断方式主要用于检测淋巴结和远处转移。
