3D THRIVE增强扫描结合曲面重建判断子宫内膜癌肌层浸润深度

目的:探讨3.0T MR 3D THRIVE动态增强扫描结合任意曲面重建技术,在判断子宫内膜癌肌层浸润深度的应用价值。材料和方法:对55例经手术病理证实的子宫内膜癌患者进行常规扫描和高分辨3D THRIVE动态增强扫描,后处理采用任意曲面重建,分析肿瘤的MR征象和肌层浸润深度,并与手术病理对照,计算两种扫描方法对肿瘤浸润肌层深度的敏感性、特异性、阳性预测值和阴性预测值。结果:采用3D THRIVE增强扫描结合曲面重建,较常规扫描能更加清晰显示病灶侵犯范围,对肿瘤局限于内膜、肿瘤浸润浅肌层、肿瘤浸润深肌层的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为75.0%、97.6%、75.0%、97.6%、95.6%;86.9%、91.3%、90.9%、87.5%、89.1%;94.7%、92.6%、90.0%、96.2%、93.5%。常规扫描则相应为50.0%、95.0%、50.0%、95.0%、91.3%;78.3%、73.9%、75.0%、77.3%、71.7%;68.4%、81.5%、72.2%、78.6%、80.4%。结论:采用高分辨3D THRIVE技术进行平扫、动态增强检查并结合曲面重建,较常规扫描判断肿瘤侵犯子宫肌层的准确性有显著提高,为临床制定正确的治疗计划提供了帮助。

3D THRIVE Scanning and Curved Reconstruction in the Assessment of Invasion Depth in Endometrial Carcinoma

Purpose:To study the value of high resolution 3D THRIVE contrast-enhanced dynamic scanning with curved multiplanar reconstruction technique using 3.0T MR in the assessment of invasion depth in endometrial carcinoma.Materials and Methods:Both routine scanning and high resolution THRIVE contrast-enhanced dynamic scanning were underwent in 55 female patients with endometrial carcinoma proved by pathology.Curved reconstruction after MR THRIVE scanning was performed.The location of the lesion and the depth of muscular invasion were analyzed and compared with pathology. The sensitivity,specificity,positive/negative predictive value,and accuracy were calculated and com- pared between THRIVE scanning and routine scanning.Results:3D THRIVE contrast-enhanced dy- namic scanning combined with curved reconstruction displayed the lesions more clearly than the routine scanning.The sensitivity,specificity,positive/negative predictive value,and accuracy in 3 conditions (confined to the endometrium,superficial myometrial invasion,deep-myometrial invasion)were 75.0%/97.6%/75.0%/97.6%/95.6%;86.9%/91.3%/90.9%/87.5%/89.1%;94.7%/92.6%/90.0%/ 96.2%/93.5%,respectively(that in routine scanning were 50.0%/95.0%/50.0%/95.0%/91.3%; 78.3%/73.9%/75.0%/77.3%/71.7%;68.4%,81.5%,72.2%,78.6%,80.4%,respectively).Conclu- sion:The accuracy of evaluating the depth of muscular invasion in patients with endometrial carcinoma using high resolution THRIVE contrast-enhanced dynamic scanning with curved reconstruction is higher than that using routine scanning.This examination method is helpful for clinical management.