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.

The value of multimodal MRI in preoperative staging and grading of endometrial carcinoma

Objective To analyze the imaging features of endometrial carcinoma derived from multimodal MRI.Methods MRI scan was performed in 45 patients with biopsy-proved endometrial carcinoma,including conventional MRI,diffusion weighted imaging(DWI),dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI),and time-signal curve (TIC).Results The diagnosis rate of DCE-MRI combined with DWI was 93.3%, and that of conventional MRI was 77.8%.Tumor differentiation was negatively correlated with ADC and rADC, and significant difference was found between G2 and G3 as well as G1 and G3 (both P<0.05).There was no significant difference between G1 and G2 (P>0.05).Of the 45 cases, 43 showed TIC type Ⅰ and type Ⅱ, and 2 showed TIC type Ⅲ, while the normal myometrium was mainly type Ⅲ curve.The difference of signal intensity of each phase (D), and enhancement rate (ER) of the lesions were lower than those of the normal myometrium.The difference was statistically significant at the phase of >30 s(P<0.05),the peak time of the former was (50±10) s.Conclusion Multimodal MRI is of great value in preoperative staging and grading of endometrial carcinoma.