阴道彩色多普勒超声与磁共振显像技术对术前子宫内膜癌肌层浸润的诊断价值

目的探讨经阴道彩色多普勒超声（TVCDS）与MRI检查对子宫内膜癌术前肌层浸润的诊断价值。方法34例子宫内膜癌患者术前均接受TVCDS与MRI检查，评估子宫内膜癌肌层浸润程度，并与术后病理检查结果进行比较。结果TVCDS判断肌层浸润的准确性为85％（29／34），浅肌层浸润的敏感性为80％（20／25），特异性9／9，阳性预测值100％（20／20），阴性预测值9／14；MRI判断肌层浸润的准确性为68％（23／34），浅肌层浸润的敏感性为60％（15／25），特异性8／9，阳性预测值15／16，阴性预测值8／18。彩色多普勒血流成像对浅肌层浸润探测到血流信号，阻力指数平均值为0．51，对深肌层浸润探测到血流信号，阻力指数平均值为0．43。结论术前TVCDS与MRI均可用于判断子宫内膜癌的肌层浸润深度，TVCDS更适合于子宫内膜癌肌层浸润的筛查。结合病灶内血流信号阻力指数有助于肌层浸润深度的判断。

Evaluation of transvaginal color Doppler sonography and magnetic resonance imaging in diagnosis for myometirial invasion of endometrial cancer

Objective To investigate the value of transvaginal color Doppler sonography (TVCDS) and magnetic resonance imaging (MRI) in diagnosis for myometrial invasion of eudometrial cancer before surgical operation, in comparison with pathological examinations. Methods TVCDS and MRI were undergone before surgical operation in 34 patients with endometrial cancer confirmed by biopsy to evaluate depth of its myometrial invasion, as compared to those with postoperative pathological examinations. Results Predictive accuracy for myometrial invasion by TVCDS was 85%, with sensitivity, specificity, positive predictive value and negative predictive value of 80%, 9/9, 100% and 9/14, respectively, and predictive accuracy by MRI was 68%, with sensitivity, specificity, positive predictive value and negative predictive value of 60%, 8/9, 15/16 and 8/18, respectively. Resistance index (RI) averaged 0.51 for flow signal to detect superfical myometrial invasion by color Doppler flow imaging (CDFI) and 0.43 for deep myometrial invasion. Conclusions TVCDS and MRI can be used before surgical operation to judge the depth of myometrial invasion for patients with endometrial cancer, particularly more suitable for its screening, which will be helpful to judge the depth of myometrial invasion incorporated with resistance index by color Doppler flow signal.