【摘要】 目的:比较DWI和DCE-MRI在子宫内膜癌中诊断肌层浸润深度和宫颈间质侵犯的准确性。方法:回顾性收集2014年1月～2018年12月在福建省妇幼保健院经手术病理证实的子宫内膜癌患者389例,所有病例均于术前行盆腔MRI检查,其中329例行磁共振常规序列检查+弥散加权成像(DWI),其余60例行磁共振常规序列检查+动态增强扫描(DCE-MRI)。将MRI结果与术后病理结果进行对比,评估DWI和DCE-MR成像在子宫内膜癌中诊断Ⅰ期和Ⅱ期的准确性。结果:DWI总体准确率77.8%(256/329);DCE-MRI总体准确率71.7%(43/60)。DWI及DCE-MRI预测Ⅰa期的灵敏度、特异度分别为89.5%、77.0%及91.2%、76.9%;预测Ⅰb期的灵敏度、特异度分别为75.0%、87.0%及69.2%、85.7%。预测Ⅱ期的灵敏度、特异度分别为33.3%、96.7%及33.3%、98.0%。结论:DWI在诊断子宫内膜癌I期上比DCE-MRI具有更高的诊断准确率。对于Ⅱ期,两者的诊断效能基本相同,但考虑到DCE-MRI造影剂的限制,DWI作为常规磁共振检查的辅助手段更加合适。更多还原

【Abstract】 Objective: To compare the accuracy of DWI and DCE-MRI in the diagnosis of myometrial invasion and cervical interstitial invasion in endometrial carcinoma. Methods: From January 2014 to December 2018, 389 cases of endometrial cancer confirmed by operation and pathology in Fujian Provincial Maternity and Children’s Hospital were collected. All patients were examined by MRI before operation, 329 of them were examined by conventional MRI sequence + DWI, and the other 60 by conventional MRI sequence + DCE-MRI. The accuracy of DWI and DCE-MR in the diagnosis of stage Ⅰ and stage Ⅱ endometrial carcinoma was evaluated by comparing the MRI results with the pathological results. Result: The accuracy of DWI and DCE-MRI was 77.8% and 71.7%. The sensitivity and specificity of DWI and DCE-MRI that predicted endometrial cancer stage Ia were 89.5%, 77.0% and 91.2%,76.9%; The sensitivity and specificity that predicted stage Ib were 75.0%,87.0% and 69.2%,85.7%; The sensitivity and specificity that predicted stage Ⅱ were 33.3%,96.7% and 33.3%, 98.0%. Conclusion: DWI has higher diagnostic accuracy than dce-mri in diagnosing endometrial cancer stage Ⅰ. For stage Ⅱ, the diagnostic efficiency of the two is the same. Considering the limitations of contrast medium, DWI is more suitable as an auxiliary means to assist MRI.更多还原