Pati Saroj Kumar, Mondal Kingshuk, Bodhey Narendra Kuber, Bagde Nilaj, Gupta Rakesh K, Shukla Arvind
Radiodiagnosis, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Obstetrics and Gynaecology, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Cureus. 2024 Jul 21;16(7):e65058. doi: 10.7759/cureus.65058. eCollection 2024 Jul.
Background Endometrial carcinoma (EC) is a major global concern in females throughout the world with increasing incidence in India. Hence, early detection and prompt intervention will reduce morbidity and mortality associated with it. Multiple studies showed a promising role of multiparametric magnetic resonance imaging (mpMRI) in the evaluation and early detection of the disease. In view of the paucity of such studies in the Indian population, we assessed the role of mpMRI in the evaluation of EC by utilizing a 3T MR scanner. Objectives To assess the efficacy of mpMRI in detecting myometrial invasion and locoregional staging in suspected or diagnosed cases of EC. Materials and methods Nineteen cases of EC with mpMRI were included in the study, and 15 of these underwent surgicopathological staging. The preoperative staging was done using the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging system based on mpMRI findings and compared with postoperative FIGO staging. All the data were compiled in a Microsoft Excel (Microsoft® Corp., Redmond, WA) file and analyzed in Statistical Product and Service Solutions (SPSS, version 21.0; IBM SPSS Statistics for Windows, Armonk, NY) using appropriate tools. Results In our study, EC was commonly seen in more than 50-year females with a predominant complaint being postmenopausal bleeding. EC most commonly appeared heterogeneously hyperintense on T2-weighted sequence (T2W) and areas of diffusion restriction on diffusion-weighted imaging (DWI) in all cases. Dynamic contrast-enhanced (DCE) MRI (DCE-MRI) showed mild heterogeneous enhancement in all phases with better delineation of adjacent myometrial infiltration in the equilibrium phase. Diffusion tensor imaging (DTI) parameters had significantly lower values in involved myometrium vis-a-vis uninvolved myometrium. A statistically significant correlation was seen between preoperative mpMRI FIGO staging utilizing T2W, DWI, DCE-MRI, and DTI with surgicopathological FIGO staging. Conclusion mpMRI, particularly T2W, DWI, DCE-MRI, and DTI, yields a significant correlation between MR imaging and histopathological findings in assessing myometrial infiltration and thereby could be helpful in preoperative staging and extent of lymph-nodal dissection.
子宫内膜癌（EC）是全球女性主要关注的问题，在印度其发病率呈上升趋势。因此，早期检测和及时干预将降低与之相关的发病率和死亡率。多项研究表明，多参数磁共振成像（mpMRI）在该疾病的评估和早期检测中具有重要作用。鉴于印度人群中此类研究较少，我们利用3T MR扫描仪评估了mpMRI在EC评估中的作用。
评估mpMRI在疑似或确诊EC病例中检测肌层浸润和局部区域分期的有效性。
本研究纳入了19例接受mpMRI检查的EC病例，其中15例接受了手术病理分期。术前分期采用基于mpMRI结果的国际妇产科联合会（FIGO）2009分期系统，并与术后FIGO分期进行比较。所有数据都汇编在一个Microsoft Excel（Microsoft® Corp., Redmond, WA）文件中，并使用适当工具在统计产品与服务解决方案（SPSS，版本21.0；IBM SPSS Statistics for Windows，Armonk，NY）中进行分析。
在我们的研究中，EC常见于50岁以上女性，主要症状为绝经后出血。在所有病例中，EC在T2加权序列（T2W）上最常表现为不均匀高信号，在扩散加权成像（DWI）上表现为扩散受限区域。动态对比增强（DCE）MRI（DCE-MRI）在所有阶段均显示轻度不均匀强化，在平衡期能更好地显示相邻肌层浸润情况。扩散张量成像（DTI）参数在受累肌层相对于未受累肌层的值显著较低。术前利用T2W、DWI、DCE-MRI和DTI进行的mpMRI FIGO分期与手术病理FIGO分期之间存在统计学显著相关性。
mpMRI，尤其是T2W、DWI、DCE-MRI和DTI，在评估肌层浸润方面，MR成像与组织病理学结果之间具有显著相关性，因此有助于术前分期和淋巴结清扫范围的确定。
