MR功能成像在子宫内膜癌的术前分期中的价值

子宫内膜癌术前准确分期对治疗方案的选择,尤其是手术方案的选择有很重要的影响,MRI是目前最准确的术前分期方法之一。综述MR动态增强成像及扩散加权成像在子宫内膜癌术前分期中的价值,并就其各自的适用范围、技术优势和局限性进行探讨。     

MRI在子宫内膜癌术前分期中的应用

子宫内膜癌是一种常见的妇科恶性肿瘤，约占女性全部恶性肿瘤的7％，术前准确分期对临床制定治疗方案有重大帮助。MRI是准确显示肿瘤侵犯肌层、宫颈的唯一影像学检查方法，并能确定宫旁组织的侵犯及淋巴结转移，因而有助于治疗前分期。就近年献中有关子宫内膜癌的MRI表现及其分期予以综述。     

MRI在子宫内膜癌术前分期中的应用

子宫内膜癌是一种常见的妇科恶性肿瘤,约占女性全部恶性肿瘤的7%,术前准确分期对临床制定治疗方案有重大帮助.MRI是准确显示肿瘤侵犯肌层、宫颈的唯一影像学检查方法,并能确定宫旁组织的侵犯及淋巴结转移,因而有助于治疗前分期.就近年文献中有关子宫内膜癌的MRI表现及其分期予以综述.     

MR功能成像在子宫内膜癌分期中的应用

【摘要】动态增强磁共振成像（DCE-MRI）、弥散加权成像（DWI）、扩散张量成像（DTI）与增强T2*加权血管成像（ESWAN）均属于磁共振的功能成像技术,具有相应的定量参数,能够从不同方面评价肿瘤的特点。子宫内膜癌是女性生殖系统常见的恶性肿瘤,不同临床分期的内膜癌患者的治疗方式、预后不同。本文就上述磁共振功能成像技术在子宫内膜癌分期方面的应用作一综述。     

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.     

多模态MRI术前诊断子宫内膜癌分期与分级的价值

目的 分析多模态MRI下子宫内膜癌的影像学特征.方法 经病理组织活检确诊的45例子宫内膜癌患者均进行MRI扫描及后处理分析,包括常规平扫、扩散加权成像(DWI)、动态增强磁共振成像(DCE-MRI)及时间-信号曲线(TIC).结果 DCE-MRI联合DWI的分期确诊率达93.3%,常规MRI为77.8%.肿瘤分化程度与ADC值呈负相关,在G2、G3及G1、G3组间差异显著(P<0.05),在G1、G2组间差异无统计学意义(P>0.05).43例子宫内膜癌TIC呈Ⅰ型及Ⅱ型,2例呈Ⅲ型,正常肌层主要为Ⅲ型,前者TIC各期信号差值(D)、强化率(ER)均低于后者,在>30 s时差异有统计学意义(P<0.05),前者达峰时间(TTP)在 (50±10) s.结论 多模态MRI对子宫内膜癌术前分期与分级的诊断具有重要价值.     

矢状面SPIR结合动态增强技术在子宫内膜癌分期中的价值

目的:探讨矢状面SPIR结合动态增强技术在子宫内膜癌分期中的价值。方法:85例经手术病理证实的子宫内膜癌患者均行MRI横断面T1WI、T2WI,矢状面T2WI SPIR、Gd-DTPA动态增强及常规横断面T1WI增强扫描,观察肿瘤、结合带及肌层侵犯情况,将矢状面SPIR结合动态增强与其它序列比较。结果:对明确肿瘤性质、判断子宫结合带中断及肌层侵犯,矢状面SPIR结合动态增强序列明显优于其它序列。结论:矢状面SPIR结合动态增强技术对子宫内膜癌术前分期有重要价值,应成为子宫内膜癌术前常规的一种检查技术。     

磁共振成像在子宫内膜癌术前分期诊断中的应用价值

目的 探讨磁共振成像(MRI)在子宫内膜癌术前分期诊断中的应用价值.方法 选择2015年1月至2019年4月我院治疗的子宫内膜癌患者98例,均接受MRI检查.以术后病理诊断结果作为金标准,分析MRI术前检查子宫内膜癌的诊断效能.结果 98例患者中,病理诊断结果为Ⅰa、Ⅰb、Ⅱ、Ⅲ、Ⅳ期分别为54例、24例、10例、6例...     

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.     

MRI对子宫内膜癌术前分期的应用价值

子宫内膜癌又称子宫体癌,是指原发于子宫内膜的上皮恶性肿瘤,是女性生殖系统最常见的恶性肿瘤之一。治疗前准确估计分期、病理分级、淋巴结转移有助于合理选择治疗方案及判断预后。磁共振成像（magnetic resonance imaging,MRI）具有多方位、多角度、多序列成像、组织分辨力高及软组织对比度好等特点,可准确显示盆腔及子宫的解剖结构,并且对病变范围、肌层浸润深度较准确定位,从而可指导临床制定正确的治疗方案。本研究对42例子宫内膜癌行高场强MRI检查,并与手术后病理结果进行对比分析,以期探讨MRI在子宫内膜癌术前分期中的应用价值。     

MRI对子宫内膜癌术前分期的研究现状与进展

子宫内膜癌是女性常见生殖系统肿瘤,肿瘤肌层浸润深度、宫颈间质受累及淋巴结转移是决定内膜癌分期及预后的重要因素。MRI是子宫内膜癌术前评估的重要检查方法,多种功能成像技术的应用提高了MRI对内膜癌的术前评估准确性。从国际妇产科联盟（FIGO）分期的修订、成像技术、常规MRI表现和功能MRI的补充作用,以及宫颈间质及淋巴结转移等方面对子宫内膜癌的MRI术前评估进行综述。      

Accuracy of breath-hold magnetic resonance imaging in preoperative staging of organ-confined renal cell carcinoma

PURPOSE: To determine the accuracy of breath-hold magnetic resonance (MR) imaging for preoperative staging of patients with organ-confined (stage I) renal cell carcinoma. MATERIALS AND METHODS: Preoperative MR examinations of 43 patients (50 lesions) who underwent nephrectomy were reviewed. The MR examination consisted entirely of breath-hold sequences, and images were retrospectively evaluated by 2 blinded radiologists. Reviewers independently evaluated each case for findings that could affect the radiologic staging, particularly those that distinguish between organ-confined (stage I) and non-organ-confined (>stage II) disease. Each reviewer assigned a stage, and results were correlated with findings at surgery and pathologic examination. RESULTS: The difference between both reviewers and pathologic findings in evaluating an intact renal capsule (stage I) was statistically significant (P < 0.05) and resulted in a statistically significant difference between radiologic and pathologic staging (Wilcoxon test, P < 0.05). The kappa test demonstrated moderate agreement between radiologic and pathologic staging (82% and 80% for reviewers 1 and 2, kappa = 0.54 and 0.80, respectively) and substantial agreement (90%, kappa = 0.80) between the 2 reviewers in assigning a radiologic stage. CONCLUSION: Breath-hold MR imaging has an accuracy ranging between 80% and 82% in staging patients with organ-confined renal cell carcinoma, with substantial (90%) agreement between readers.     

Role of magnetic resonance in the staging of endometrial carcinoma

Biopsy is the technique of choice for the definitive diagnosis of endometrial carcinoma. Since lymphatic tumor spread has been demonstrated to depend on the degree of myometrial involvement, the definition of the latter with imaging techniques may significantly affect both prognosis and therapy. We investigated, by means of MR imaging at 0.5 T, 14 patients with endometrial carcinoma, to assess both tumor stage and myometrial involvement. FIGO staging system was employed, and M parameter evaluated (M0 = no myometrial involvement; M1 = involvement confined to the inner third; M2 = involvement confined to the middle third; M3 = involvement of the whole myometrium). Another parameter was the characteristic high signal of the tumor on PD and T2W images. The patients were then operated and MR information was correlated with surgical findings. Overall diagnostic accuracy of MR imaging was 85.7% in tumor staging, and 92.2% in defining M parameter. Tumor spread into adnexa and into cervical canal was poorly demonstrated by MR imaging.     

MR对声门上型喉癌分期的价值

目的：探讨MR对声门上型喉癌术前T分期的准确性，为治疗方案选择提供影像学依据。方法：对手术切除的48例声门上型喉癌的MR资料进行分析，观察肿瘤侵犯范围及有无颈淋巴结转移，按双盲法根据MR表现进行T分期并与手术病理结果进行对比。结果：NR术前肿瘤T分期的准确性为89．5％(43／48)，判断肿瘤侵犯周围结构的准确性在85％～100％之间，诊断颈部淋巴结的准确性为89％(24／27)。结论：MR能准确判断肿瘤的侵犯范围，准确判断有无淋巴结的转移，对临床治疗方案的选择具有重要意义。     

Accuracy of nasopharyngeal carcinoma staging by magnetic resonance imaging

To audit the accuracy of magnetic resonance (MR) staging of nasopharyngeal carcinoma (NPC) in daily reporting, the MR images of 101 adult patients with newly diagnosed NPC reported between December 1996 and February 2002 were reviewed retrospectively. Based on the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) TNM staging criteria (1997), the tumour staging obtained from the MR reports and the MR films was compared by two experienced head and neck radiologists. The number of patients being upstaged, downstaged or unchanged was noted. In all stages, the NPC staging obtained from the MR reports revealed 18 (17.8%) understaged, eight (7.9%) overstaged and 75 (74.2%) the same stage when compared to the staging obtained from the MR films based on the AJCC/UICC criteria. The percentage of patients being understaged or overstaged, in decreasing order of frequency, were stages II, III, IV and I. Magnetic resonance of NPC should be reported by radiologists who are not only familiar with the pathology of this condition and its pattern of spread but who should also base their reports on the AICC/UICC staging criteria. The necessity to improve our MR staging accuracy is largely because it determines the type of therapy to be given and this has to be appropriate and adequate for a successful treatment.     

双源CT和功能磁共振成像对肝内胆管细胞癌术前精准T分期的评价

目的 探讨双源CT(dual source CT,DSCT)和功能磁共振成像(fMRI)对肝内胆管细胞癌(ICC)术前精准T分期诊断的准确性及其临床应用价值.方法 选取2017年1月～2019年12月间在本院进行手术切除治疗的肝内胆管细胞癌患者,所有患者均在术前两周内行DSCT和fMRI扫描检查.以术后病理分期结果为金...     

Accuracy in staging carcinoma of the bladder by magnetic resonance imaging

Thirty-four patients with a presumptive diagnosis of carcinoma of the bladder diagnosed at EUA and cystoscopy have been staged by MRI and the findings correlated with pathology in 15 patients and clinical follow-up, including repeat cystoscopy, in the remainder. MRI is accurate in identifying tumours confined to the bladder wall or extending beyond the wall to involve perivesical fat or adjacent organs. Whilst it is not possible to distinguish between T1, T2 or early T3a tumours they can be distinguished from advanced T3a lesions and this may affect management. MRI is superior to clinical staging, particularly in detecting lymphadenopathy and provides information for optimal radiotherapy planning. The problem of distinguishing between the effects of radiotherapy and suspected recurrent tumour is discussed.     

Magnetic resonance imaging in the preoperative assessment of clinical stage I endometrial carcinoma

Magnetic resonance (MR) imaging may aid in preoperative treatment planning of endometrial carcinoma by accurately estimating tumor volume, depth of myometrial invasion, and extrauterine extension. Preoperative MR scans were obtained on 24 women with clinical stage I endometrial cancer. MR scans were evaluated for uterine size, as an indirect measure of tumor volume, and depth of myometrial invasion. MR detected deep invasion (greater than or equal to 50% of myometrial thickness) with a sensitivity of 71% and specificity of 83% (accuracy 79%) when compared with the pathologic findings. MR staging may assist in deciding which patients should have lymph node dissection at surgery and may aid in decisions regarding adjunctive radiation therapy.