子宫内膜癌局部分期的磁共振成像：静脉注射造影剂是否仍有必要？

MRI for local staging of endometrial carcinoma: Is endovenous contrast medium administration still needed?

作者信息

Bonatti Matteo, Stuefer Josef, Oberhofer Nadia, Negri Giovanni, Tagliaferri Tiziana, Schifferle Günther, Messini Sergio, Manfredi Riccardo, Bonatti Giampietro

机构信息

Department of Radiology of Bolzano Central Hospital, 5 Böhler St., 39100 Bolzano, Italy.

出版信息

Eur J Radiol. 2015 Feb;84(2):208-14. doi: 10.1016/j.ejrad.2014.11.010. Epub 2014 Nov 20.

DOI:10.1016/j.ejrad.2014.11.010

PMID:25440994

Abstract

PURPOSE

To compare the diagnostic performance of T2-weighted images (T2-WI)+contrast-enhanced T1-weighted images (CE T1-WI) with the one of T2-WI+diffusion-weighted images (DWI) in the assessment of myometrial and cervical stromal infiltration by endometrial carcinoma (EC).

MATERIALS AND METHODS

Institutional review board approved our retrospective study; requirement for informed consent was waived. 56 patients with histologically proven EC who underwent preoperative MRI and surgery at our Institution over a 34 months period were included. Two radiologists independently evaluated T2-WI+CE T1-WI and T2-WI+DWI of each patient. Confidence in imaging evaluation (0-3), depth of myometrial invasion (</≥50%) and presence of cervical stromal infiltration (Yes/No) were assessed. MRI findings were compared with pathological ones.

RESULTS

Confidence in imaging evaluation was higher for T2-WI+CE T1-WI (2.83/3) than for T2-WI+DWI (2.62/3). T2-WI+DWI showed a better diagnostic performance than T2-WI+CE T1-WI in recognizing deep myometrial infiltration by EC (accuracy, sensitivity and specificity of 0.89, 0.89 and 0.89 vs. 0.86, 0.84, 0.86; p>0.05) whereas both imaging sequences combinations showed the same diagnostic performance in recognizing cervical stromal infiltration (accuracy, sensitivity and specificity of 0.95, 0.98 and 0.80, p>0.05).

CONCLUSION

T2-WI+DWI can reliably replace the "classical" combination T2-WI+CE T1-WI for local staging of endometrial carcinoma.

摘要

目的

比较T2加权成像（T2-WI）+对比增强T1加权成像（CE T1-WI）与T2-WI+扩散加权成像（DWI）在评估子宫内膜癌（EC）肌层和宫颈基质浸润方面的诊断性能。

材料与方法

机构审查委员会批准了我们的回顾性研究；豁免了知情同意的要求。纳入了56例在34个月内于我院接受术前MRI检查和手术且经组织学证实为EC的患者。两名放射科医生独立评估每位患者的T2-WI+CE T1-WI和T2-WI+DWI。评估成像评估的信心（0-3分）、肌层浸润深度（＜/≥50%）以及宫颈基质浸润的存在情况（是/否）。将MRI结果与病理结果进行比较。

结果

T2-WI+CE T1-WI的成像评估信心（2.83/3分）高于T2-WI+DWI（2.62/3分）。在识别EC的深部肌层浸润方面，T2-WI+DWI的诊断性能优于T2-WI+CE T1-WI（准确率、敏感度和特异度分别为0.89、0.89和0.89，对比0.86、0.84和0.86；p＞0.05），而在识别宫颈基质浸润方面，两种成像序列组合的诊断性能相同（准确率、敏感度和特异度分别为0.95、0.98和0.80，p＞0.05）。