术前盆腔对比增强MRI评估子宫内膜癌子宫肌层浸润程度

目的 探讨术前盆腔对比增强MRI对子宫内膜癌子宫肌层浸润程度的诊断价值。方法 回顾性分析89例经手术病理确诊的子宫内膜癌患者，术前均以盆腔对比增强MRI评估肌层浸润程度，并与术后病理结果进行比较，评价术前对比增强MRI对子宫内膜癌肌层浸润程度的诊断效能。结果 术前盆腔MRI示病变区子宫内膜均呈不均匀中-高信号强度，子宫肌层内边缘不清，结合带中断，受累肌壁呈不均匀高信号。术前对比增强MRI诊断62例浅肌层浸润，27例深肌层浸润；术后病理诊断浅肌层浸润63例，深肌层浸润26例。术前对比增强MRI诊断浅肌层浸润的敏感度90.48%（57/63），特异度80.77%（21/26），阳性预测值91.94%（57/62），阴性预测值77.78%（21/27），准确率87.64%（78/89）；诊断深肌层浸润敏感度80.77%（21/26），特异度90.48%（57/63），阳性预测值77.78%（21/27），阴性预测值91.94%（57/62），准确率87.64%（78/89）。结论 术前盆腔对比增强MRI评估子宫内膜癌子宫肌层浸润程度的效能较高。

Contrast-enhanced pelvic MRI for preoperative evaluation on degree of myometrial infiltration of endometrial carcinoma

Objective To investigate the diagnostic value of preoperative contrast-enhanced pelvic MRI for evaluation on the degree of myometrial infiltration of endometrial carcinoma. Methods Totally 89 endometrial carcinoma patients confirmed with surgical pathology were retrospectively analyzed. Preoperative contrast-enhanced pelvic MRI scanning was performed to evaluate the degree of myometrial infiltration, and the results were compared with those of postoperative pathology. The diagnostic efficacy of contrast-enhanced MRI for evaluation on the degree of myometrial infiltration of endometrial carcinoma was analyzed. Results Preoperative pelvic MRI showed uneven medium to high signal intensity in the lesion area of the endometrium. The inner edge of the myometrium was unclear, the junction zone was interrupted, and the uneven high signal intensity were seen in myometrium. Preoperative contrast-enhanced MRI diagnosed 62 cases of superficial myometrial infiltration and 27 cases of deep myometrial infiltration. Postoperative pathological results showed 63 cases of superficial myometrial infiltration and 26 cases of deep myometrial infiltration. The sensitivity of preoperative contrast-enhanced pelvic MRI for diagnosing superficial myometrial infiltration was 90.48% (57/63), the specificity was 80.77% (21/26), the positive and negative predictive value was 91.94% (57/62) and 77.78% (21/27), respectively, and the accuracy of 87.64% (78/89). The sensitivity of MRI for diagnosing deep myometrial infiltration was 80.77% (21/26), the specificity was 90.48% (57/63), the positive and negative predictive value was 77.78% (21/27), and 91.94% (57/62), respectively, and the accuracy was 87.64% (78/89). Conclusion Preoperative contrast-enhanced pelvic MRI was effective in assessing the degree of myometrial infiltration of endometrial cancer.