子宫内膜癌的磁共振表现及分期

目的:探讨子宫内膜癌的MRI表现,评价MRI在子宫内膜癌的诊断及术前分期中的价值.方法:23例子宫内膜癌患者术前行MRI检查,按照1998年FIGO修订分期原则将所有病例分期,并与术后病理结果进行对照分析.采用列联表的x2检验及配对资料的x2检验.结果:子宫内膜癌的癌灶在T2 WI上表现为子宫内膜不规则增厚,信号不均匀且高于肌层,并有不均匀强化.本组显示MRI对子宫内膜癌分期准确率为87%(20/23),对肌层浸润深度判断的准确率为76.9%(10/13).结论:MRI能多方位清晰显示子宫内膜癌瘤灶及侵犯范围,对子宫内膜癌的诊断及术前分期具有很高的价值.     

功能磁共振成像在子宫内膜癌中的应用及进展

子宫内膜癌是女性生殖系统最常见的恶性肿瘤之一,严重威胁妇女健康.MRI具有良好的软组织分辨力,能多方位、多层面成像,因此成为妇科肿瘤的重要检查方法.常规MRI在子宫内膜癌的诊断及分期等方面具有重要价值,但也存在局限性.随着影像学技术的快速发展,MRI已从单纯的形态解剖学成像发展为功能成像,以动态增强MRI和扩散加权成像为代表的功能成像在子宫内膜癌的诊断和分期方面有着巨大的潜能.就功能磁共振成像在子宫内膜癌中的应用及进展予以综述.     

子宫内膜癌的MRI研究进展

子宫内膜癌是常见女性生殖系统恶性肿瘤之一,近年来发病率持续上升,术前准确的分期对治疗及预后有重要意义。MRI检查在子宫内膜癌的诊断及分期中具有非常重要的价值,可提高子宫内膜癌术前分期的准确度,有助于治疗计划的选择和制定,并在随访复查中发挥重要作用。     

子宫内膜癌的MRI诊断价值

目的：分析子宫内膜癌病人的MRI表现,评价MRI对子宫内膜癌的诊断价值。方法：对36例手术证实子宫内膜癌病人的MRI进行回顾性分析,依据FIGO分期原则,将术前MRI分期与术后病理结果进行比较研究。结果：以病理结果为基准,MRI判断肌层侵犯的准确率为77．8％（28／36）,分期准确率为86．1％（31／36）。结论：MRI能够清晰地显示子宫内膜癌的病灶范围及肌肉侵犯情况,术前诊断及分期价值较高,建议常规检查。     

子宫内膜癌的MRI诊断进展

子宫内膜癌在女性生殖系统恶性肿瘤中占首位,存在内源性和外源性高危因素,术前分期对治疗有重要影响,预后与组织学类型及分期也密切相关。MRI检查在子宫内膜癌的诊断中具有非常重要的价值,通过采用适当的检查技术和扫描方案,能够对子宫内膜癌正确诊断和准确分期,有助于临床治疗计划的制定,并在随访复查中发挥重要作用。     

子宫内膜癌的MRI诊断进展

子宫内膜癌在女性生殖系统恶性肿瘤中占首位,存在内源性和外源性高危因素,术前分期对治疗有重要影响,预后与组织学类型及分期也密切相关。MRI检查在子宫内膜癌的诊断中具有非常重要的价值,通过采用适当的检查技术和扫描方案,能够对子宫内膜癌正确诊断和准确分期,有助于临床治疗计划的制定,并在随访复查中发挥重要作用。     

磁共振成像诊断子宫内膜癌和术后病理基础分析

目的分析子宫内膜癌磁共振成像（MRI）的表现,探讨MRI在子宫内膜癌诊断及术后病理基础分析的意义。方法回顾性分析我院收治80例子宫内膜癌患者的MRI表现及临床资料,并进行分析,所有患者术后经病理证实。结果子宫内膜癌MRI表现为宫体增大,内膜增厚,可准确判断肿瘤部位、大小、侵犯范围及有无转移等。结论MRI对子宫内膜癌的诊断、肿瘤分期判断有较高价值,与术后病理分期相比较,准确率较高,对临床上制订治疗方案及术后预后评估具有重要指导意义。     

子宫内膜癌的MRI诊断价值

子宫内膜癌是女性生殖系统最常见的恶性肿瘤，对其准确诊断和分期与治疗方案的选择及预后有着密切关系。MRI是子宫内膜癌术前分期最准确的影像学检查方法，能够正确指导治疗方式的选择。     

子宫内膜癌的MRI诊断价值

子宫内膜癌是女性生殖系统最常见的恶性肿瘤,对其准确诊断和分期与治疗方案的选择及预后有着密切关系.MRI是子宫内膜癌术前分期最准确的影像学检查方法,能够正确指导治疗方式的选择.     

DWI和高分辨率T2WI结合在子宫内膜癌诊断和分期中的价值

目的评价扩散加权成像(DWI)和高分辨T2WI结合与常规T2WI对比,用于子宫内膜癌诊断和分期方面的能力及优势。方法共50例经病理证实子宫内膜癌患者,实验组:25例行DWI和高分辨T2WI结合扫描;对照组:25例行常规T2WI扫描。术前分别进行诊断与分期,与术后病理学结果进行统计学分析。实验组选取扩散b值800,对病灶信号强度观察及ADC值测量统计分析。结果实验组对于子宫内膜癌诊断和分期准确率为92%,对照组为68%,两组差别有统计学意义,实验组子宫内膜癌病灶DWI图像的信号强度明显增高,ADC值明显减低,均值为(0.78±0.06)×10-3 mm2/s)。结论与常规T2WI相比,DWI和高分辨T2WI结合在子宫内膜癌诊断和分期方面具有明显优势。     

The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis

Functional imaging by means of dynamic multiphase contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted magnetic resonance imaging (DW-MRI) is now part of the standard imaging protocols for evaluation of the female pelvis. DCE-MRI and DW-MRI are important MR imaging techniques which enable the radiologist to move from morphological to functional assessment of diseases of the female pelvis. This is mainly due to the limitations of morphologic imaging, particularly in lesion characterization, accurate lymph node staging, assessment of tumour response and inability to differentiate post-treatment changes from tumour recurrence.DCE-MRI improves the accuracy of T2WI in staging of endometrial cancer. It also helps differentiate tumour recurrence from radiation fibrosis in patients with cervical cancer. DCE-MRI improves characterization of cystic adnexal lesions and detection of small peritoneal implants in patients with ovarian cancer.DW-MRI is valuable in preoperative staging of patients with endometrial and cervical cancer, especially in detection of extra-uterine disease. It does increase reader's confidence for detection of recurrent disease in gynaecological malignancies and improves detection of small peritoneal implants in patients with ovarian cancer.In this review article we give an overview of both DCE-MRI and DW-MRI techniques, concentrating on their main clinical application in the female pelvis, and present a practical approach of the added value of these techniques according to the main pathological conditions, highlighting the pearls and pitfalls of each technique.     

Imaging of uterine cancer

Although surgical staging is the primary method of assessing prognostic factors in endometrial cancer, cross-sectional imaging may help in treatment planning by providing information about factors such as the depth of myometrial invasion, cervical involvement, and nodal status. The pretreatment evaluation of cervical cancer traditionally has consisted of clinical evaluation, laboratory tests, and conventional radiographic studies, but more advanced imaging methods allow additional insights into the morphologic and metabolic features of cervical cancer. This article reviews the applications of modern imaging modalities in the assessment of endometrial cancer and cervical cancer and their impact on treatment planning and posttreatment follow-up.     

Molecular imaging of cancer: MR spectroscopy and beyond

Proton magnetic resonance spectroscopic imaging is a non-invasive diagnostic tool for the investigation of cancer metabolism. As an adjunct to morphologic and dynamic magnetic resonance imaging, it is routinely used for the staging, assessment of treatment response, and therapy monitoring in brain, breast, and prostate cancer. Recently, its application was extended to other cancerous diseases, such as malignant soft-tissue tumours, gastrointestinal and gynecological cancers, as well as nodal metastasis. In this review, we discuss the current and evolving clinical applications of proton magnetic resonance spectroscopic imaging. In addition, we will briefly discuss other evolving techniques, such as phosphorus magnetic resonance spectroscopic imaging, sodium imaging and diffusion-weighted imaging in cancer assessment.     

DWI结合高分辨T_2WI磁共振在子宫内膜癌分期中的价值

目的:探讨DWI结合高分辨T2WI在子宫内膜癌分期中的价值。方法:回顾性分析70例经手术病理证实的子宫内膜癌DWI及高分辨T2WI表现,测量其ADC值,判断其浸润范围,并与术后病理结果相比较。结果:DWI结合高分辨T2WI对子宫内膜癌2009FIGO分期准确性为94.3%,评价浅肌层、深肌层浸润的敏感度、特异度和准确度分别为94.5%、82.4%、94.3%和83.3%、95.3%、94.3%;评价子宫内膜癌宫颈基质浸润的敏感度、特异度和准确度分别为100%、100%和100%。结论:DWI结合高分辨T2WI磁共振能够提高子宫内膜癌浸润深度评价的准确度,有助于子宫内膜癌的诊断、分期及帮助制定治疗计划。     

子宫内膜癌的MRI诊断及分期研究

目的探讨子宫内膜癌的MRI表现,评价MRI对子宫内膜癌术前分期的价值. 资料与方法 24例经手术病理证实的子宫内膜癌患者术前均行MRI检查,横断位、矢状位、冠状位 SE T1WI, 横断位、矢状位、冠状位TSE T2WI,Gd-DTPA增强后T1WI横断位、矢状位、冠状位扫描.在MRI上观察肿瘤位置、信号特征及侵犯肌层的深度.MRI所见与手术病理对比. 结果子宫内膜癌的表现:子宫增大,子宫内膜弥漫性不规则增厚,T1WI呈低信号,T2WI为相对高信号,有强化,侵犯肌层时,则T2WI上子宫肌层信号增高,结合带中断,显示不清.MRI对子宫内膜癌分期总的准确度为83.3%. 结论 MRI能多方位清晰地显示子宫内膜癌瘤灶及侵犯范围和深度,明显优于其他影像检查方法;MRI对术前子宫内膜癌分期也明显优于其他影像检查方法,故MRI应成为子宫内膜癌术前常规的影像检查方法.     

FIGO staging system for endometrial cancer: added benefits of MR imaging

Endometrial cancer is the most commonly diagnosed gynecologic malignancy in the United States. This pathologic condition is staged with the International Federation of Gynecology and Obstetrics (FIGO) system. The FIGO staging system recently underwent significant revision, which has important implications for radiologists. Key changes incorporated into the 2009 FIGO staging system include simplification of stage I disease and removal of cervical mucosal invasion as a distinct stage. Magnetic resonance (MR) imaging is essential for the preoperative staging of endometrial cancer because it can accurately depict the depth of myometrial invasion, which is the most important morphologic prognostic factor and correlates with tumor grade, presence of lymph node metastases, and overall patient survival. Diffusion-weighted MR imaging and dynamic contrast medium-enhanced MR imaging are useful adjuncts to standard morphologic imaging and may improve overall staging accuracy.     

Imaging of endometrial adenocarcinoma

Endometrial cancer is the most common gynaecological malignancy and the incidence rising. Prognosis depends on age of patient, histological grade, depth of myometrial invasion and cervical invasion and lymph node metastases. Myometrial invasion and accurate cervical involvement cannot be predicted clinically. Pre-treatment knowledge of these criteria is advantageous in order to plan treatment. The clinical challenge is to effectively select patients at risk of relapse for more radical treatment whilst avoiding over treating low risk cases. This is important as endometrial cancer predominately occurs in postmenopausal women with co-morbidities. Modern imaging provides important tools in the accurate pre-treatment assessment of endometrial cancer and may optimize treatment planning. However, there is little consensus to date on imaging in the routine preoperative assessment of endometrial carcinoma and practice varies amongst many gynaecologists. Transvaginal ultrasound is often the initial imaging examination for women with uterine bleeding. However, once the diagnosis of endometrial cancer has been made, contrast-enhanced magnetic resonance imaging (MRI) provides the best assessment of the disease. The results of contrast-enhanced MRI may identify patients who need more aggressive therapy and referral to a cancer centre. In this article we review the role of imaging in the diagnosis and staging/preoperative assessment of endometrial carcinoma.     

进展期胃癌影像学研究进展

本文对进展期胃癌影像学研究的最新成果进行了归纳和分析,着重阐述胃癌各种检查方法的价值、具体操作、影像学表现、术前分期、后处理技术及限度。目前较为成熟的观点是双对比造影检查依然是胃癌检测首选方法,CT和MRI在胃癌的诊断和分期上具有巨大的潜力,但有其固有的局限性,多种检查方法的联合应用将进一步提高胃癌术前检查的准确性。     

MRI of malignant neoplasms of the uterine corpus and cervix

OBJECTIVE: In this article, we review the role of MRI in the imaging of malignant neoplasms of the uterine corpus and cervix, describing its role in staging, treatment planning, and follow-up. CONCLUSION: MRI is not officially incorporated in the International Federation of Gynecology and Obstetrics (FIGO) staging system, but is already widely accepted as the most reliable imaging technique for the diagnosis, staging, treatment planning, and follow-up of both endometrial and cervical cancer. MRI protocols need to be optimized to obtain the best results and avoid pitfalls.     

MRI三维动态增强与扩散加权成像在子宫内膜癌分期与分级中的应用

目的 探讨3.0T MR三维肝脏容积加速采集(LAVA)动态增强检查在子宫内膜癌分期中的价值,分析不同病理级别内膜癌表观扩散系数(ADC)的差异.资料与方法 回顾性分析73例经手术病理证实为Ⅰ、Ⅱ期子宫内膜癌术前MR资料,评估LAVA增强检查分期各期(2009年FIGO分期标准)肿瘤的敏感性、特异性和准确性;比较各病理级别肿瘤间ADC值的差异.结果 以手术病理为标准,LAVA增强检查判断内膜癌Ⅰa、Ⅰb、Ⅱ期的敏感性、特异性、准确性分别为93.2％、77.8％、100.0％,83.3％、93.6％、100.0％,91.1％、91.1％、100.0％.G1、G2、G3级内膜癌平均ADC值分别为(0.78±0.14)× 10-3mm2/s、(0.64±0.06)×10-3mm2/s、(0.40±0.09)×10-3mm2/s,三者间两两比较差异均有统计学意义(P＜0 01).结论 3.0TMR 3DLAVA动态增强检查对Ⅰ、Ⅱ期子宫内膜癌的分期有较高的价值;测量ADC值对鉴别不同病理级别内膜癌有潜在价值,级别越高,ADC值趋于越低.