Savci G, Ozyaman T, Tutar M, Bilgin T, Erol O, Tuncel E
Department of Radiology, Uludag University Medical Faculty, Gorukle Campus, TR-16 059 Bursa, Turkey.
Eur Radiol. 1998;8(2):218-23. doi: 10.1007/s003300050365.
A prospective study was undertaken to assess the value of both T2-weighted spin-echo (SE) and contrast-enhanced dynamic gradient-echo (GRE) sequences using MR imaging in differentiating the deep myometrial invasion from lower stages produced by endometrial carcinoma. For the correlation of MR findings with the histopathologic findings, patients who had no myometrial invasion (stage 1 a) and patients in whom tumors were confined to the superficial myometrium (stage 1 b) at pathologic examination were combined as lower stages. Twenty patients with endometrial carcinoma were studied using both techniques. The absence of any detectable tumor (stage 1 a) or the presence of a tumor confined to inner half of myometrium (stage 1 b) and extention of tumor to the outer half of myometrium (stage 1 c) were used as the diagnostic criteria. In pathologic examination of excised specimens, deep myometrial invasion was detected in 9 of 20 patients. The sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of T2-weighted SE in differentiating deep myometrial invasion from combined lower stages were 88, 91, 90, 88, and 91 %, respectively, whereas corresponding values for contrast-enhanced dynamic GRE sequences were 78, 100, 90, 100, and 85 %. Statistical difference between two sequences did not reach a significant level. We conclude that in cases of absence of visible junctional zone with SE sequence, contrast-enhanced dynamic GRE MR imaging may be helpful.
开展了一项前瞻性研究，以评估使用磁共振成像（MR）的T2加权自旋回波（SE）序列和对比增强动态梯度回波（GRE）序列在鉴别子宫内膜癌引起的深层肌层浸润与较低分期方面的价值。为了使MR检查结果与组织病理学结果相关联，将病理检查中无肌层浸润（1a期）的患者和肿瘤局限于浅肌层（1b期）的患者合并为较低分期。对20例子宫内膜癌患者使用这两种技术进行了研究。将未检测到任何肿瘤（1a期）、肿瘤局限于肌层内半部分（1b期）以及肿瘤延伸至肌层外半部分（1c期）作为诊断标准。在切除标本的病理检查中，20例患者中有9例检测到深层肌层浸润。T2加权SE序列在鉴别深层肌层浸润与合并的较低分期时的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）分别为88%、91%、90%、88%和91%，而对比增强动态GRE序列的相应值分别为78%、100%、90%、100%和85%。两个序列之间的统计学差异未达到显著水平。我们得出结论，在SE序列未显示可见结合带的情况下，对比增强动态GRE MR成像可能会有帮助。
