Huang Yu-Ting, Chang Chun-Bi, Yeh Chi-Ju, Lin Gigin, Huang Huei-Jean, Wang Chun-Chieh, Lu Kuan-Ying, Ng Koon-Kwan, Yen Tzu-Chen, Lai Chyong-Huey
Department of Medical Imaging and Intervention, Imaging Core Laboratory, Institute for Radiological Research, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Gueishan, Taoyuan, Taiwan.
Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
J Magn Reson Imaging. 2018 Feb 13. doi: 10.1002/jmri.25981.
Assessment of tumor extent and lymphatic metastasis of uterine carcinosarcomas is important for treatment planning.
PURPOSE/HYPOTHESIS: To evaluate the diagnostic accuracy of 3.0T diffusion-weighted (DW) MRI for patients with uterine carcinosarcoma, in assessment of tumor extent and lymphatic metastasis.
Retrospective diagnostic accuracy study.
A consecutive cohort of 68 patients with pathologically proved carcinosarcoma between January 2006 and July 2014.
FIELD STRENGTH/SEQUENCE: 3T DW MRI.
Maximal tumor and uterus size, presence of deep myometrial invasion, cervical invasion, adnexal invasion, lymphadenopathy, and the apparent diffusion coefficient (ADC) values of each tumor were used. Histopathology was the gold standard.
Diagnostic accuracy. Logistic regression.
In all, 38 patients entered the final analysis, with median age of 58 years (range, 35-79 years). The sensitivity and specificity in detecting deep myometrial invasion, cervical stromal invasion, adnexal invasion, as well as pelvic and para-aortic lymph node metastases were 65% and 72%, 91% and 85%, 50% and 100%, 33% and 89%, and 33% and 100%, respectively. The largest tumor diameters predicted deep myometrium invasion (anteroposterior direction, P = 0.004) and cervical stroma invasion (craniocaudal direction, P = 0.008). Tumor ADC significantly predicted the lymphovascular permeation (P = 0.025; odds ratio = 0.96).
Preoperative DW MRI is useful to assess deep myometrial or cervical stromal invasion in uterine carcinosarcoma, yet the diagnostic performance for detecting adnexal invasion and lymphatic metastasis requires further improvement.
3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
评估子宫癌肉瘤的肿瘤范围和淋巴转移情况对治疗方案的制定很重要。
目的/假设：评估3.0T扩散加权（DW）磁共振成像（MRI）对子宫癌肉瘤患者肿瘤范围和淋巴转移的诊断准确性。
回顾性诊断准确性研究。
2006年1月至2014年7月间连续入选的68例经病理证实为癌肉瘤的患者。
场强/序列：3T DW MRI。
测量肿瘤和子宫的最大尺寸，判断是否存在肌层深部浸润、宫颈浸润、附件浸润、淋巴结肿大，并测量每个肿瘤的表观扩散系数（ADC）值。组织病理学为金标准。
诊断准确性分析。逻辑回归分析。
共有38例患者进入最终分析，中位年龄58岁（范围35 - 79岁）。检测肌层深部浸润、宫颈间质浸润、附件浸润以及盆腔和腹主动脉旁淋巴结转移的敏感度和特异度分别为65%和72%、91%和85%、50%和100%、33%和89%、33%和100%。肿瘤最大直径可预测肌层深部浸润（前后径，P = 0.004）和宫颈间质浸润（头脚径，P = 0.008）。肿瘤ADC值可显著预测淋巴管浸润（P = 0.025；优势比 = 0.96）。
术前DW MRI有助于评估子宫癌肉瘤的肌层深部或宫颈间质浸润，但检测附件浸润和淋巴转移的诊断性能有待进一步提高。
3 技术效能：2级 《磁共振成像杂志》2018年
