3.0T磁共振LAVA动态增强判断子宫内膜癌肌层浸润深度的价值

目的探讨3.0T磁共振肝脏快速容积采集技术(LAVA)动态增强判断子宫内膜癌肌层浸润深度的应用价值。资料与方法回顾性分析52例子宫内膜癌的T2WI和LAVA动态增强图像,以手术病理结果为标准,计算两种序列诊断子宫内膜癌肌层浸润的敏感性、特异性、阳性预测值、阴性预测值和准确性。结果 T2WI判断内膜癌肌层浸润及深肌层浸润的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为84.4%、71.4%、95.0%、41.7%、82.7%和63.6%、82.9%、50.0%、89.5%、78.8%。LAVA动态增强判断内膜癌肌层浸润及深肌层浸润敏感性、特异性、阳性预测值、阴性预测值和准确性分别为93.3%、85.7%、97.7%、66.7%、92.3%和90.9%、95.1%、83.3%、97.5%、94.2%。LAVA动态增强判断子宫内膜癌深肌层受侵的准确性高于T2WI诊断的准确性,差异有统计学意义(P<0.05)。结论 3.0T磁共振LAVA动态增强扫描有助于提高子宫内膜癌肌层浸润术前诊断的准确性。     

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。     

MR动态增强和扩散加权成像评估子宫内膜癌宫颈间质浸润的对照研究

【摘要】目的：对比MR动态增强（DCE）和扩散加权成像（DWI）评估子宫内膜癌宫颈间质浸润的价值。方法：回顾性分析2009年2月-2017年2月天津医科大学总医院手术确诊为子宫内膜癌的250例患者的术前盆腔MRI资料,由两位医师分别在DWI联合T2WI、DCE联合T2WI序列下评估是否存在宫颈间质浸润,计算并对比两种序列评估宫颈间质浸润的符合率、敏感度、特异度、阳性预测值和阴性预测值,同时分析影响不同序列判断子宫内膜癌宫颈间质浸润的因素。结果：医师1采用DCE+T2WI和DWI+T2WI判断宫颈间质浸润的符合率、敏感度、特异度、阳性预测值和阴性预测值分别为98.4%、96.3%、98.7%、90.0%、99.6%和95.2%、92.6%、95.5%、71.4%、99.1%;医师2采用DCE+T2WI和DWI+T2WI判断宫颈间质浸润的符合率、敏感度、特异度、阳性预测值和阴性预测值分别为94.0%、88.9%、94.6%、66.7%、98.6%和88.4%、74.1%、90.1%、47.6%、96.6%。DCE联合T2WI序列判断宫颈间质浸润的符合率高于DWI。子宫峡部受累是影响DWI判断宫颈间质浸润的主要因素。结论：MR动态增强联合常规T2WI序列对于判断子宫内膜癌宫颈间质浸润优于扩散加权成像。     

联合应用MR动态增强及T_2WI对Ⅰ、Ⅱ期子宫内膜癌的诊断价值

目的:评价MR动态增强、T2WI二者结合对Ⅰ、Ⅱ期子宫内膜癌的诊断价值。方法:回顾性分析36例经手术病理证实的子宫内膜癌的T1WI、T2WI和动态增强图像,将MRI判断肌层和宫颈侵犯结果与手术病理比较。结果:MRI动态增强及T2WI二者结合判断子宫内膜癌浸润深度诊断符合率为80.6%,对Ⅰa期的敏感性、特异性,阳性预测值、阴性预测值分别为85.7%、93.1%、75%、96.4%;Ⅰb期的敏感性、特异性,阳性预测值、阴性预测值分别为76.5%、84.2%、81.3%、80%;Ⅰc期的敏感性、特异性,阳性预测值、阴性预测值分别为83.3%、91.7%、83.3%、91.7%;Ⅱ期的敏感度为80%,特异度为96.8%,诊断符合率为94.4%。结论:联合应用MRI动态增强及T2WI判断子宫内膜癌侵犯肌层的深度、范围有很高的临床价值,能够指导临床治疗方式的选择。     

Ⅰ、Ⅱ期子宫内膜癌MRI表现与病理对照研究

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。     

3.0 T MR动态增强与扩散加权成像诊断子宫内膜癌肌层受侵的对比研究

目的 比较3.0 TMR动态增强扫描(DCE-MRI)与扩散加权成像(DWI)术前评估子宫内膜癌肌层浸润深度的准确性.方法 回顾分析2011年5月至2012年8月38例经手术病理证实为子宫内膜癌患者的术前MRI资料.MRI扫描包括:T2WI、DWI(b值为0,1000 s/mm2)及DCE-MRI.评估不同成像方法的子宫内膜癌肌层浸润情况,并与术后病理结果对照.通过SPSS 17.0统计分析软件,运用诊断实验方法计算子宫内膜癌肌层浸润的敏感性、特异性、阳性预测值、阴性预测值和准确性,并采用配对卡方检验确切概率法比较不同成像方法对肌层浸润的准确性.而不同成像方法判断肌层浸润的影响因素分析采用Fisher,s确切概率法.结果 T2WI诊断子宫内膜癌肌层浸润的准确性为73.7％,DCE-MRI联合T2 WI为84.2％,DWI联合T2WI为91.2％.DWI联合T2WI诊断肌层浸润的准确性要高于DCE-MRI联合T2WI和单独T2WI,其中DWI联合T2WI与单独T2WI之间差异具有统计学意义(P =0.014 ＜0.05).DWI评估肌层浸润时不受混杂因素的影响(P值均＞0.05),而肿瘤浸润宫角是DCE-MRI诊断错误的唯一影响因素(P =0.007 ＜0.05).结论 DWI在评估子宫内膜癌肌层浸润时具有与DCE-MRI相当的准确性,应作为子宫内膜癌患者的常规检查序列.     

磁共振多序列成像在子宫内膜癌肌层浸润中的诊断价值

【摘要】目的:探讨T2WI、动态增强成像（DCE）、DWI及联合序列(T2WI+DCE+DWI)在Ⅰ期子宫内膜癌肌层浸润中的诊断价值。方法:回顾性分析经手术病理证实为Ⅰ 期子宫内膜癌的43例患者的术前MRI资料,分别应用T2WI、DCE、DWI及联合序列对肿瘤肌层浸润深度进行评估,并与病理结果进行对照分析。结果:T2WI、DCE、DWI、联合序列对子宫内膜癌肌层浸润深度的诊断准确率分别为83.72%、88.10%、80.49%、93.02%,4种检查方法的诊断准确率差异无统计学意义（P>0.05）。T2WI、DCE、DWI、联合序列与病理结果的一致性Kappa值分别为0.57、0.66、0.48、0.78。结论：磁共振T2WI、DCE、DWI及联合序列对I期子宫内膜癌肌层浸润深度均具有较高的诊断价值,其中DCE、联合序列与术后病理结果具有高度一致性,T2WI、DCE及DWI序列均是子宫内膜癌术前肌层浸润深度评估的可靠检查方法。     

T_2WI、DWI及动态增强技术在子宫内膜癌肌层浸润深度判定中的价值

目的探讨3.0T磁共振成像中T_2WI、DWI及动态增强在子宫内膜癌肌层浸润深度判定中的价值。方法回顾性分析均行3.0T MRI检查且手术病理证实的91例子宫内膜癌患者的资料,将T_2WI、DWI及动态增强对肌层浸润深度的判断结果与手术病理结果进行对照分析。结果 T_2WI序列对子宫内膜癌肌层浸润的判断总符合率为59.3%,DWI判断总符合率为64.8%,动态增强序列总符合率为92.3%,对深肌层浸润诊断的敏感性T_2WI、DWI、动态增强为100%,特异度分别为87.2%、88.4%、97.7%。Kappa一致性检验,动态增强序列与术后病理一致性较好,而常规T_2WI序列、DWI序列一致性较差。结论动态增强扫描,可显著提高对子宫肌层浸润评估的准确性,为临床手术方式的选择提供重要的指导价值。     

3D LAVA动态增强扫描结合MPR技术判断子宫内膜癌肌层浸润深度的价值

目的探讨3.0TMR 3D肝脏容积超快速采集(liver acquisition with volume acceleration,LAVA)动态增强扫描结合多平面重组(multiplanar reconstruction,MPR)技术在判断子宫内膜癌肌层浸润深度的应用价值。资料与方法对55例经手术病理证实为2009国际妇产科联盟会(FIGO)Ⅰ期的子宫内膜癌患者行常规扫描和高分辨3DLAVA动态增强扫描,后者采用高压注射器经肘前静脉以2.5~3.0 ml/s的流率注入Gd-DTPA 0.2 mmol/kg体重,分别于注药后15 s、45 s、90 s、120 s、150 s及180 s 6个时相屏气扫描,分析肿瘤与正常外肌层在各个时相的强化趋势,分别计算每个增强时相肿瘤与正常外肌层的对比噪声比(CNR)。选取CNR最大时相的增强图像,采用MPR技术判断肿瘤肌层浸润深度,并与手术病理对照。根据2009年FIGO子宫内膜癌新分期的标准,即ⅠA期(局限于内膜+浸润浅肌层)、ⅠB期(浸润深肌层),计算LAVA结合MPR技术对肿瘤浸润肌层深度的敏感性、特异性、阳性预测值、阴性预测值和准确性。结果在动态增强图像上,所有...     

国际妇产科协会子宫内膜癌分期标准的修订与超声诊断的探讨

目的依据2009年国际妇产科协会(FIGO)修订的子宫内膜癌手术分期标准,探讨子宫内膜癌的超声表现与手术分期的相关性。资料与方法对208例经病理证实的子宫内膜癌(71例)及内膜增生过长(137例)患者的声像图表现及病理分型与分期进行分析。结果内膜癌组宫腔回声厚径(6.1～59.0mm,19.1mm±10.2mm)与增生过长组测值(3.8～43.9mm,13.3mm±5.8mm)互有交叉,两组比较差异有统计学意义(P<0.01)。检出Ⅰ型子宫内膜癌63例,Ⅱ型子宫内膜癌8例;Ⅰ期55例,Ⅱ期11例,Ⅲ期3例,Ⅳ期2例。肌层浸润的发生率为93.0%(66/71),深肌层浸润占18.0%(13/71);11例Ⅱ期癌中,浅肌层浸润8例,深肌层浸润3例;3例Ⅲ期癌均为浅肌层浸润;2例Ⅳ期癌,深、浅肌层浸润各1例。结论内膜癌组宫腔回声厚径的平均值明显大于增生过长组,二者所测值存在重叠;当病变局限在子宫体,肌层浸润的深度影响分期;如病变已达宫颈或宫外,肌层浸润的深度则不影响分期。     

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.     

Can dynamic contrast enhanced magnetic resonance imaging change treatment planning in endometrial carcinoma?

Purpose

To detect the diagnostic accuracy of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the assessment of myometrium and cervix infiltration and lymph node (L.N) status in patients with endometrial carcinoma.

Patients and methods

Forty patients with pathologically proven endometrial carcinoma underwent preoperative MRI assessment in the National Cancer Institute, Cairo University, Egypt over three years from 2009 to 2012. Every case had one stage for the T2 weighted images (T2 WIs) alone and another stage for the combined T2 and DCE images according to the revised international federation of gynecology and obstetrics (FIGO) classification. The pathological findings after surgery were the reference standard.

Results

The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of T2 WIs in detection of deep myometrial invasion were 80%, 72%, 70%, 84% and 79%, respectively and 87%, 90%, 85%, 92% and 87%, respectively for DCE-MRI. For cervical infiltration, T2 WIs showed 78.5%, 88%, 73%, 90.5% and 82.5%, respectively while DCE-MRI showed 92%, 97%, 92%, 97% and 95%, respectively. T2 WIs and DCE-MRI had 100% sensitivity and 85% specificity for the detection of L.N metastasis.

Conclusion

DCE-MRI can accurately detect invasion of the myometrium and cervix in cases of endometrial carcinoma.     

Assessment of the myometrial infiltration of endometrial carcinoma (FIGO stage I-II). The accuracy of magnetic resonance (1.5 T)

Thirty-three patients with histological diagnosis of endometrial carcinoma were studied with MR imaging at 1.5 T. All patients were clinically diagnosed as having stage I or II disease (FIGO) and underwent abdominal hysterectomy. MR tissue characteristics and morphological features were compared with morphological features were compared with microscopic pathological findings, in all patients. The following initials were adopted for statistical comparison: M0 = tumor confined to endometrium; M1 = infiltration of the inner third of myometrium; M2 = invasion of the central third of myometrium; M3 = infiltration of the outer third of myometrium. T1-weighted (SE 600/30) and T2-weighted (SE 2000/35.90) (SE 1500/28.60) images were obtained in sagittal plane (section thickness = mm 4). Overall MR accuracy in determining the extent of myometrial invasion was 78%. Correct evaluation of myometrial invasion is essential in patients with stage I or II endometrial carcinoma who are to undergo transvaginal hysterectomy without lymphadenectomy (M0, M1).     

FIGOⅠ Ⅱ期子宫内膜癌MRI征象分析与评价

目的:按照FIGO2009分期标准,分析ⅠⅡ期子宫内膜癌的MRI征象及其病理基础,评价MRI对子宫内膜癌肌层和宫颈侵犯的诊断价值。方法:43例ⅠⅡ期子宫内膜癌患者术前均行MRI检查,采用双盲法,描述肿瘤的MRI表现特征,并将MRI术前分期及判断肌层和宫颈浸润结果,与术后病理结果对照分析。结果:Ⅰa 26例,Ⅰb 8例,Ⅱ期9例。Ⅰ期MRI主要表现为子宫内膜增厚、腔内局限型或弥漫性软组织肿块呈中等强化、T2WI低信号结合带中断及肌层侵犯等,其病理基础为癌细胞呈腺样乳突状结构,突破粘膜层,向肌壁间浸润性生长。Ⅱ期以宫颈内出现与宫体肿瘤相连续的异常信号影及宫颈纤维间质破坏为特征。MRI评价肿瘤浸润肌层深度的诊断准确性为86%,判断宫颈侵犯的敏感性、特异性、准确性分别为78%、91%、88%,与病理结果比较无显著性差异(P0.05)。结论:MRI对Ⅰ、Ⅱ期子宫内膜癌的早期诊断、肌层和宫颈侵犯的判断及术前分期准确性高,具有较高的临床应用价值。     

MRI evaluation of myometrial invasion by endometrial carcinoma. Comparison between fast-spin-echo T2w and coronal-FMPSPGR Gadolinium-Dota-enhanced sequences

PURPOSE: The depth of myometrial invasion by endometrial carcinoma strongly affects the incidence of metastasis to regional nodes and influences the surgical strategies. The aim of this paper is to compare the results of FSE T2-w and Gadolinium-enhanced FMPSGR MR sequences in assessing the depth of myometrial invasion by endometrial cancer. MATERIALS AND METHODS: Forty-five women with histopathologically-proven endometrial carcinoma underwent preoperative MRI. Axial SE T1w, axial, sagittal and para-coronal FSE T2w and para-coronal Gadolinium-enhanced FMPSGR sequences were performed using a high field strength magnet (1.5T). Within one month of MR all patients underwent hysterectomy, and anatomical evaluation of the surgical specimen was done sectioning the uterus along the short axis. Based upon the results of the histological evaluation the results of the FSE T2w and Gadolinium-enhanced sequences were compared and the statistical difference between the results obtained was statistically evaluated. RESULTS: The histological evaluation showed intramucosal neoplasm in 11 patients, myometrial infiltration less than 50% in 31 patients, myometrial infiltration more than 50% in 12 patients and transmural cancer in 1 patient. Statistical evaluation showed that the FSE T2w sequence had a global sensitivity and specificity of 80.6% and 87.6%, respectively, with a mean Negative Predictive Value of 92.6% and a mean Positive Predictive Value of 86%. Gadolinium-enhanced FMPSPGR sequence had a global sensitivity and specificity of 90.6% and 93.3%, respectively, with a mean Negative Predictive Value of 96,3% and a mean Positive Predictive Value of 88%. The staging accuracy (chi2 test) on FMPSPGR images (95%) was higher than that on FSE T2w images (78%). CONCLUSIONS: In our experience Gadolinium-enhanced dynamic sequences increase the accuracy of MR imaging in diagnosing the depth of myometrial invasion. In particular they improve the visualisation of the inner myometrium, the so called subendometrial enhancing zone, whose disruption or changes are essential for diagnosing myometrial invasion. The major diagnostic advantages of the enhanced sequences were found in postmenopausal women, where visualisation of the junctional zone may be difficult in the T2w sequences. We believe that Gadolinium-enhanced dynamic sequences should be used whenever the diagnosis is unclear at FSE T2w sequences.     

Magnetic resonance with endorectal coil in the local staging of prostatic carcinoma. Comparison with histologic macrosections in 40 cases]

PURPOSE: Endorectal coil MRI is widely used in the diagnostic workup of prostate cancer, but diagnostic accuracy rates reported in the literature are quite variable. We report our personal experience with endorectal coil MRI in the local staging of prostate carcinoma. MATERIAL AND METHODS: Forty consecutive patients with histologically proved prostate carcinoma were examined with endorectal coil MRI at high field strength (1.5 T). All patients underwent a sagittal T1-weighted SE location sequence (TR 400, TE 20), an axial T1-weighted SE (TR 400, TE 20), two axial T2-weighted FSE sequences (TR 3000, TE 102, ETL 8) with and without fat suppression, and a coronal T2-weighted FSE sequence (TR 3000, TE 102, ETL 8); an axial Fast Multiplanar Spoiled Gradient Recalled (FMSPGR) dynamic sequence after Gd-DTPA injection was also performed in 18 patients. MR staging of local tumor spread was done according to the current literature criteria. All patients were submitted to radical prostatectomy, and histologic macrosections on the same plane as MR images were obtained from surgical specimens. MR and histologic staging were compared to assess MR accuracy in detecting capsular infiltration, seminal vesicles and apex involvement. The diagnostic yield of Gd-DTPA was also investigated. RESULTS: MRI correctly staged 31 of 40 cases (77.5%). MR accuracy was 80% in detecting capsular infiltration (85.7% sensitivity and 73.6% specificity), 90% in seminal vesicle involvement (91.6% sensitivity, 89.2% specificity) and 72.5% in apex involvement (79.1% sensitivity, 62.5% specificity). Dynamic studies with Gd-DTPA did not improve staging accuracy in any case. DISCUSSION AND CONCLUSIONS: In agreement with most of the current literature, MRI showed moderate overall accuracy in the local staging of prostate carcinoma. Particularly, MRI had good accuracy in detecting seminal vesicle involvement but moderate sensitivity and specificity in demonstrating capsular infiltration and apex involvement. Due to its high cost, MRI should not be routinely used in prostate cancer staging but should be reserved to the patients whose clinical and serological data suggest extraprostatic tumor spread, whose preoperative demonstration could avoid noncurative surgery.     

Local-regional staging of endometrial carcinoma: role of MR imaging in surgical planning

PURPOSE: To assess magnetic resonance (MR) imaging in depicting the depth of myometrial infiltration, cervical invasion, and presence of enlarged lymph nodes in patients with endometrial adenocarcinoma compared with surgicopathologic findings. MATERIALS AND METHODS: Thirty-seven consecutive patients with endometrial carcinoma were included in this prospective study. All patients underwent MR imaging and surgery. Qualitative image analysis included the depth of myometrial infiltration, infiltration of the uterine cervix, and presence of enlarged lymph nodes. Quantitative image analysis included tumor and myometrium contrast-to-noise ratios during different phases of dynamic imaging. MR imaging findings were compared with surgicopathologic findings. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values of MR imaging in depicting myometrial and cervical infiltration and in lymph node assessment were calculated. RESULTS: Respective sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values in assessing myometrial infiltration were 87%, 91%, 89%, 87%, and 91%; those for cervical infiltration, 80%, 96%, 92%, 89%, and 93%; and those for lymph node assessment, 50%, 95%, 90%, 50%, and 95%. There was significant agreement between MR imaging and surgicopathologic findings in assessment of myometrial invasion (P <.001). Myometrial and cervical invasion and lymph node enlargement were correctly assessed with MR imaging in 28 (76%) of 37 patients. Quantitative analysis showed a significant improvement in tumor and myometrium contrast-to-noise ratios during the equilibrium phase compared with the arterial and precontrast phases (P <.001). CONCLUSION: MR imaging coupled with contrast material-enhanced dynamic MR imaging is highly accurate in local-regional staging of endometrial carcinoma; more challenging is the assessment of pelvic and lumboaortic lymph nodes.     

A thickened or indistinct junctional zone on T2-weighted MR images in patients with endometrial carcinoma: pathologic consideration based on microcirculation

Thickened or indistinct junctional zone (JZ) is a problematic finding in staging endometrial carcinoma. We studied the incidence, pathological cause of this condition correlated to microcirculation, and the utility of dynamic contrast MRI for differential diagnosis. T2-weighted images were analyzed in 119 cases with endometrial carcinoma. The enhancement of the JZ during the dynamic contrast MRI, histopathological causes, and the density of arterioles in the JZ were retrospectively analyzed in cases with thickened or indistinct JZ. The MRI histopathological correlation of all 31 patients with a thickened or indistinct JZ were analyzed, in which it was corresponded to myometrial cancer invasion only in 22%. The sensitivity of a poor early enhancement pattern on dynamic study for detecting myometrial invasion was 71.4%, the specificity was 100%, and the overall accuracy was 92.5%. Although only weak relationship between the contrast enhancement and the arteriole density was revealed, the arteriole density within the JZ with cancer invasion was significantly decreased. Poor enhancement of JZ in early dynamic phase was correlated with the decreased density of arterioles within the myometrium which was invaded by endometrial carcinoma. Dynamic contrast study should be performed in staging endometrial carcinoma especially when JZ was thickened or indistinct.