Tang X, Muramatsu Y, Yajima M, Sonoda T
Department of Gynecology, National Cancer Center Hospital, Tokyo.
Jpn J Clin Oncol. 1993 Oct;23(5):278-83.
In order to improve the accuracy of magnetic resonance (MR) imaging assessment of myometrial invasion by endometrial cancer, the usefulness of a new diagnostic parameter, the endometrium-myometrium (EM) ratio has been evaluated. EM ratio is the proportion of the widest length of endometrium to the length of myometrium measured at the same line, this being vertical to the parallel of the long axis of the uterine body in the sagittal plane of the MR images. Myometrial invasion was defined as a value of the EM ratio > 1, and the tumor was limited to the endometrium for values < 1. In 25 consecutive patients, both the EM ratio-based assessment and the well-established junctional zone-based assessment with T2-weighted MR imaging and enhanced MR imaging with gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) were compared with the results from pathological examinations of postoperative specimens. In identifying myometrial invasion by endometrial cancer, the sensitivity of the EM ratio-based assessment was better than that of the junctional zone-based assessment. The overall sensitivity of the former was 96% in both the T2-weighted and enhanced MR imaging with Gd-DTPA, whereas that of the latter was 84% in the T2-weighted MR imaging and 72% (P < 0.05) in the enhanced MR imaging. The use of the EM ratio with MR imaging improves the ability to assess myometrial invasion by endometrial cancer.
为提高磁共振（MR）成像评估子宫内膜癌肌层浸润的准确性，已对一种新的诊断参数——子宫内膜与肌层（EM）比值的实用性进行了评估。EM比值是在MR图像矢状面中，与子宫体长轴平行方向垂直的同一条线上测量的子宫内膜最宽长度与肌层长度的比例。肌层浸润定义为EM比值>1，而当比值<1时，肿瘤局限于子宫内膜。在连续的25例患者中，将基于EM比值的评估以及基于成熟的结合带的评估（采用T2加权MR成像和钆喷酸葡胺（Gd-DTPA）增强MR成像）与术后标本的病理检查结果进行了比较。在识别子宫内膜癌的肌层浸润方面，基于EM比值的评估的敏感性优于基于结合带的评估。在T2加权和Gd-DTPA增强MR成像中，前者的总体敏感性均为96%，而后者在T2加权MR成像中的敏感性为84%，在增强MR成像中的敏感性为72%（P<0.05）。在MR成像中使用EM比值可提高评估子宫内膜癌肌层浸润的能力。
