评估子宫内膜癌的肌层浸润深度：正交骨盆-轴位对比增强与子宫-轴位动态对比增强 MRI 方案的比较。
Evaluation of the Depth of Myometrial Invasion of Endometrial Carcinoma: Comparison of Orthogonal Pelvis-axial Contrast-enhanced and Uterus-axial Dynamic Contrast-enhanced MRI Protocols.
机构信息
Department of Radiology, Jinshan Hospital, Fudan University, Longhang Road, Shanghai 201508, People's Republic of China.
Department of Radiology, Jinshan Hospital, Fudan University, Longhang Road, Shanghai 201508, People's Republic of China.
出版信息
Acad Radiol. 2022 Aug;29(8):e119-e127. doi: 10.1016/j.acra.2021.09.011. Epub 2021 Oct 11.
RATIONALE AND OBJECTIVES
To compare the diagnostic performance of orthogonal pelvis-axial (OPA) contrast-enhanced (CE) and orthogonal uterus-axial (OUA) dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) protocols in assessing the depth of myometrial invasion (MI) of endometrial carcinoma (EC).
MATERIALS AND METHODS
Preoperative MRI of 398 consecutive EC patients (197 patients with OPA CE-MRI protocol and 201 patients with OUA DCE-MRI protocol) was analyzed. Two radiologists independently interpreted the depth of MI, with postoperative histopathology as the reference standard. The chi-square test, Fisher's exact test, and receiver operating characteristic curve analysis were used for diagnostic performance comparison.
RESULTS
OUA DCE-MRI showed a significantly larger area under the curve than OPA CE-MRI in detecting the presence of MI for radiologist 1 (0.71 versus 0.49, p < 0.05) but not for radiologist 2 or deep MI (all p > 0.05). Compared to OPA CE-MRI, OUA DCE-MRI significantly improved the diagnostic accuracy of non-MI and superficial MI (radiologist 1: 45.5% versus 0 and 88.7% versus 86.4%, p = 0.045 and 0.567, respectively; radiologist 2: 45.5% versus 12.5% and 88.7% versus 78.8%, p = 0.177 and 0.027, respectively) and of EC with adenomyosis/submucous myomas, cornual tumor, and antero-posterior diameter ≤ 10 mm (radiologist 1: 86.4% versus 71.4%, 91.2% versus 67.7%, and 90.1% versus 81.1%, p = 0.048, 0.018, and 0.081, respectively; radiologist 2: 86.4% versus 64.3%, 88.2% versus 64.5%, and 87.0% versus 71.6%, p = 0.006, 0.023, and 0.019, respectively).
CONCLUSION
The OUA DCE-MRI protocol was superior to the OPA CE-MRI protocol in assessing the depth of MI of EC.
目的
比较正交骨盆-轴向（OPA）对比增强（CE）和正交子宫-轴向（OUA）动态对比增强（DCE）磁共振成像（MRI）方案在评估子宫内膜癌（EC）肌层浸润（MI）深度方面的诊断性能。
材料与方法
对 398 例连续 EC 患者的术前 MRI（OPA CE-MRI 方案 197 例，OUA DCE-MRI 方案 201 例）进行分析。两位放射科医生独立解读 MI 深度，以术后组织病理学为参考标准。采用卡方检验、Fisher 确切检验和受试者工作特征曲线分析进行诊断性能比较。
结果
OUA DCE-MRI 方案在检测 MI 存在方面的曲线下面积显著大于 OPA CE-MRI 方案，对放射科医生 1 而言（0.71 比 0.49，p < 0.05），但对放射科医生 2 或深部 MI 而言（均 p > 0.05）则不然。与 OPA CE-MRI 方案相比，OUA DCE-MRI 方案显著提高了非 MI 和浅层 MI 的诊断准确性（放射科医生 1：45.5%比 0 和 88.7%比 86.4%，p = 0.045 和 0.567；放射科医生 2：45.5%比 12.5%和 88.7%比 78.8%，p = 0.177 和 0.027），以及伴有腺肌症/黏膜下肌瘤、宫角肿瘤和前后径≤10 mm 的 EC（放射科医生 1：86.4%比 71.4%、91.2%比 67.7%和 90.1%比 81.1%，p = 0.048、0.018 和 0.081；放射科医生 2：86.4%比 64.3%、88.2%比 64.5%和 87.0%比 71.6%，p = 0.006、0.023 和 0.019）。
结论
OUA DCE-MRI 方案在评估 EC 肌层浸润深度方面优于 OPA CE-MRI 方案。
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