多模态MRI对子宫内膜癌诊断及病理分型临床应用价值

目的探讨多模态MRI对子宫内膜癌诊断及病理分型临床价值。方法选取我院80例子宫内膜癌疑似患者,均行多模态MRI检查,以分段诊断性刮宫病理结果为金标准计算多模态MRI诊断子宫内膜癌的漏误诊率、灵敏/特异度及病理分型敏感特异性,建立接受者操作特征(ROC)曲线分析多模态MRI诊断子宫内膜癌的效能,对比不同类型患者的表观弥散系数(ADC)值。结果金标准诊断显示,80例疑似患者中经分段诊断性刮宫病理检查最终确诊子宫内膜癌共53例(66.25%)。MRI扫描显示,多模态MRI诊断子宫内膜癌的符合率81.25%、误诊率14.81%、漏诊率20.75%、灵敏度79.25%、特异度85.19%、阳性预测值91.30%;多模态MRI对Ⅰ型子宫内膜癌的分型敏感性67.57%、特异性81.40%、阳性预测值75.75%,对Ⅱ型子宫内膜癌的分型敏感性81.25%、特异性81.25%、阳性预测值52.00%。子宫内膜癌患者ADC低于非癌患者(t=11.284),Ⅰ型患者ADC低于Ⅱ型患者(t=2.133),高分化患者ADC高于低分化患者,Ⅲ期患者ADC低于Ⅰ~Ⅱ期患者(t=2.478),以上差异均有统计学意义(P<0.05)。结论多模态MRI对子宫内膜癌具有较高的筛查诊断效能,可通过多模态MRI影像组学特征及ADC数值差异进行子宫内膜癌临床诊断。

Sensitivity,specificity and positive predictive value of multimodal MRI imaging omics in the pathological classification of endometrial carcinoma

Objective To investigate the value of multimodal MRI imaging in the diagnosis and pathological classification of endometrial carcinoma.Methods 80 suspected patients with Endometrial carcinoma in our hospital from January 2019 to January 2021 were selected.All suspected patients were diagnosed by multimodal MRI.Taking the pathological results of segmented diagnostic curettage as the gold standard,the leakage/misdiagnosis rate,sensitivity/specificity and pathological type sensitivity/specificity of multimodal MRI in the diagnosis of endometrial cancer were calculated,and the receiver operating characteristics(ROC)were established the efficacy of multimodal MRI in the diagnosis of endometrial cancer was analyzed by curve analysis,and the apparent diffusion coefficient(ADC)values of different types of patients were compared.Results The gold standard diagnosis showed that 53 cases(66.25%)of 80 suspected patients were finally diagnosed as endometrial cancer by sectional diagnostic curettage.MRI scan showed that the coincidence rate of multimodal MRI in the diagnosis of endometrial cancer was 81.25%,the misdiagnosis rate was 14.81%,the missed diagnosis rate was 20.75%,the sensitivity was 79.25%,the specificity was 85.19%,and the positive predictive value was 91.30%;The sensitivity,specificity and positive predictive value of multimodal MRI for type I endometrial carcinoma were 67.57%,81.40%and 75.75%,while for type II endometrial carcinoma,the sensitivity,specificity and positive predictive value were 81.25%,81.25%and 52.00%.The ADC of endometrial cancer patients was lower than that of non cancer patients(t=11.284),that of type I patients was lower than that of type II patients(t=2.133),that of well differentiated patients was higher than that of poorly differentiated patients,and that of stage III patients was lower than that of stage I~II patients(t=2.478).The above differences were statistically significant(P<0.05).Conclusion Multimodal MRI has high screening and diagnostic efficiency for endometrial cancer.The clinical diagnosis and pathological classification of endometrial cancer can be carried out through the imaging histological characteristics of multimodal MRI and the difference of ADC value.