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[磁共振成像用于子宫内膜癌术前局部分期:南特地区经验]

[Magnetic Resonance Imaging for local preoperative staging in endometrial cancer: Nantes local experience].

作者信息

Coussoou C, Laigle-Quérat V, Loussouarn D, Vaucel E, Frampas E

机构信息

Service de radiologie et imagerie médicale, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.

Service de radiologie et imagerie médicale, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.

出版信息

Gynecol Obstet Fertil Senol. 2020 Apr;48(4):374-383. doi: 10.1016/j.gofs.2020.02.001. Epub 2020 Feb 10.

Abstract

OBJECTIVES

To determine the diagnostic accuracy of magnetic resonance imaging (MRI) for local preoperative staging in endometrial cancer in our center (Centre Hospitalier Universitaire de Nantes: CHU), since the French National Cancer Institute's surgery recommendations publication in 2010, especially for the prediction of myometrial and cervical stromal invasion.

METHODS

Retrospective monocentric study of consecutive women operated of endometrial cancer in gynecology department of CHU de Nantes, who underwent preoperative pelvic MRI in our Radiology department from November 2010 to November 2016. MRI data collected from initial report and compared to surgical histological findings as gold standard.

RESULTS

Sixty-four patients were included. Deep myometrial invasion was present in 35 patients in MRI versus 34 patients on postoperative histology (5 false positives, 4 false negatives). Cervical stromal invasion was present in 9 patients in MRI versus 19 patients on postoperative histology (2 false positives, 12 false negatives). The sensitivity and the specificity were respectively 88.23% (95% confidence intervals (CI) [0.71-0.96]) and 83.33% (CI [0.64-0.93]) for the deep myometrial invasion; 36.84% (CI [0.17-0.61]) and 95.55% (CI [0.83-0.99]) for the cervical stromal invasion.

CONCLUSION

Our results were comparable to the literature data, with a low sensitivity for the cervical stromal invasion detection, driving us to change our MRI protocol with optional high-resolution T2 sequences perpendicular to the cervical canal if necessary.

摘要

目的

自法国国家癌症研究所2010年发布手术建议以来,确定磁共振成像(MRI)对我们中心(南特大学医院中心:CHU)子宫内膜癌局部术前分期的诊断准确性,尤其是对子宫肌层和宫颈间质浸润的预测。

方法

对南特大学医院中心妇科接受子宫内膜癌手术的连续女性进行回顾性单中心研究,这些女性在2010年11月至2016年11月期间在我们放射科接受了术前盆腔MRI检查。从初始报告中收集MRI数据,并与作为金标准的手术组织学结果进行比较。

结果

纳入64例患者。MRI显示35例有子宫肌层深部浸润,术后组织学检查显示34例(5例假阳性,4例假阴性)。MRI显示9例有宫颈间质浸润,术后组织学检查显示19例(2例假阳性,12例假阴性)。子宫肌层深部浸润的敏感性和特异性分别为88.23%(95%置信区间(CI)[0.71 - 0.96])和83.33%(CI [0.64 - 0.93]);宫颈间质浸润的敏感性和特异性分别为36.84%(CI [0.17 - 0.61])和95.55%(CI [0.83 - 0.99])。

结论

我们的结果与文献数据相当,宫颈间质浸润检测的敏感性较低,促使我们在必要时更改MRI方案,增加垂直于宫颈管的可选高分辨率T2序列。

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