摘要
目的:分析Ⅰ期和Ⅱ期子宫内膜癌的MRI表现,评价MRI对子宫内膜癌肌层和宫颈侵犯的价值。方法:回顾性分析30例经手术病理证实的Ⅰ、Ⅱ期子宫内膜癌的T1WI、T2WI和动态增强图像,观察肿瘤的类型、信号、强化特点及结合带与内膜下强化的显示情况,将MRI判断肌层和宫颈侵犯的结果与病理比较。结果:弥漫型子宫内膜癌14例,表现为子宫内膜广泛增厚;局灶型子宫内膜癌16例,表现为宫腔内结节状病灶或较大肿块。与子宫肌层相比,肿瘤T1WI多为等信号,T2WI多为高信号。动态增强早期13例弥漫型子宫内膜癌呈轻至中度强化,15个局灶型肿瘤呈明显或中度强化。T2WI显示结合带18例,动态增强早期显示内膜下强化17例。以手术病理结果为标准,MRI判断深肌层侵犯的敏感度、特异度和诊断符合率分别为87.5%、95.5%和93.3%,判断宫颈侵犯的敏感度、特异度和诊断符合率分别为75%、95.5%和90%。结论:MRI评价子宫内膜癌肌层和宫颈侵犯准确可靠,应列为术前常规检查。
Objective:To analyze MRI features of FIGO stage Ⅰand Ⅱ endometrial carcinoma and to study the value of MRI in assessing myometrial invasion and cervical involvment of endometrial carcinoma.Methods:Thirty patients with surgicopathologically-proved endometrial carcinoma were included in this retrospective study.All patients underwent T_1-weighted spin-echo,T_2- weighted fast spin-echo and dynamic contrast-enhanced fast multiplanar spoiled gradient echo sequences before surgery.The type,signal intensity and enhancement feature of the tumors,and the appearance of junctional zone or subendometrial enhancement were analyzed.The MRI diagnosis of myometrial invasion and cervical involvment were correlated with pathologic findings.Results:Endometrial carcinoma demonstrated diffuse widening of endometrium (n=14) or focal nodule or large mass in the endometrial cavity (n=16).The tumors were usually isointense relative to the myometrium on T1WI and hyper-intensity on T_2WI.In the early phase of dynamic contrast-enhanced sequence,diffuse endometrial carcinoma usually showed mild (n=8) or moderate (n=5) enhancement,while focal endometrial carcinoma tended to enhance markedly (n=6) or moderately (n=9).On T_2WI junctional zone was seen in 18 cases.On dynamic contrast-enhanced images subendometrial enhancement was seen in 17 cases.The sensitivity,specificity and accuracy of dynamic contrast-enhanced images combining with T_WI were 87.5%,95.5% and 93.3% for assessing deep myometrial invasion,and 75%,95.5% and 90% for assessing cervical involvment.Conclusion:MRI is accurate and reliable in the evaluation of myometrial invasion and cervical involvment of endometrial carcinoma,and should be performed as preoperative routine clinical examination.
出处
《放射学实践》
2005年第7期583-586,共4页
Radiologic Practice
关键词
子宫内膜肿瘤
磁共振成像
病理学
Endometrial neoplasms
Magnetic resonance imaging
Pathology
