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.

MRI Diagnosis and Staging of Endometrial Carcinoma

Objective To discuss MRI features of endometrial carcinoma and to evaluate MRI in its preoperative staging.Materials and Methods Preoperative MRI of the pelvis was performed in 24 patients with pathologically proved endometrial carcinoma. MRI included SE T 1WI, TSE T 2WI and Gd-DTPA enhanced SE T 1WI with axial, sagittal and coronal scanning. The location and signal features of the lesion and the depth of muscular invasion were observed. The findings were compared with pathologic results.Results MRI findings included enlarged uterus, diffuse and irregular thickening of the endometrium, low signal on T 1WI and relative high signal on T 2WI, presence of enhancement, increased signal of muscular layer when it was involved, and blurred and interrupted junction zone. The staging accuracy of MRI was 83.3%.Conclusion MRI can clearly display the endometrial carcinoma and its extent and depth from different directions. MRI is obviously superior to other imaging modalities in preoperative staging of the tumor. Therefore, MRI should be regarded as a routine exam for endometrial carcinoma before operation.