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目的比较不同核磁共振成像(MRI)检测方法在评估子宫内膜癌患者深肌层浸润中的临床价值。方法 50例子宫内膜癌患者,分别对其采用T2加权信号(T2WI)、增强T1加权信号(CE T1WI)和弥散加权信号(DWI)等方法行MRI扫描检测,评估深层肌层浸润程度,并将其与手术病理结果进行对比。结果 50例子宫内膜癌患者中,34例患者经手术病理证实为有肌层浸润,占68.0%;16例患者经手术病理证实为无肌层浸润,占32.0%。经T2WI检测有肌层浸润的准确性为80.0%,敏感性为88.2%,特异性为62.5%,阳性预测价值为83.3%,阴性预测价值为71.4%;经CE T1WI检测有肌层浸润的准确性为78.0%,敏感性为82.4%,特异性为68.8%,阳性预测价值为84.8%,阴性预测价值为64.7%;经DWI检测有肌层浸润的准确性为82.0%,敏感性为91.2%,特异性为62.5%,阳性预测价值为83.8%,阴性预测价值为76.9%;经T2WI和CE T1WI联合检测的准确性为90.0%,敏感性为94.1%,特异性为81.3%,阳性预测价值为91.4%,阴性预测价值为86.7%;经T2WI和DWI联合检测的准确性为96.0%,敏感性为97.1%,特异性为93.8%,阳性预测价值为97.1%,阴性预测价值为93.8%。T2WI和DWI联合检测的准确性、敏感性、特异性以及阳性预测价值、阴性预测价值均明显高于其他检测方法,差异均有统计学意义(P<0.05)。结论 T2WI和DWI联合检测能够更好的显示子宫内膜癌深肌层浸润程度,可以为临床诊断提供可靠的依据,提高诊断准确率。
Objective To compare the clinical value of different magnetic resonance imaging (MRI) detection in the evaluation of deep myometrial invasion in patients with endometrial cancer. Methods Fifty patients with endometrial carcinoma were evaluated with MRI scan for T2DM, T2WI, CE T1WI and DWI to evaluate the degree of deep myometrial invasion. It is compared with the surgical pathology results. Results Of the 50 cases of endometrial cancer, 34 cases were proved to have myometrial invasion by operation and pathology, accounting for 68.0%. 16 cases were diagnosed as myometrial invasion by operation and pathology, accounting for 32.0%. The accuracy of myometrial invasion by T2WI was 80.0%, the sensitivity was 88.2%, the specificity was 62.5%, the positive predictive value was 83.3% and the negative predictive value was 71.4%. The accuracy of myometrial invasion by CE T1WI The sensitivity was 82.4%, the specificity was 68.8%, the positive predictive value was 84.8%, the negative predictive value was 64.7%. The accuracy of myometrial invasion by DWI was 82.0% and the sensitivity was 91.2% , The specificity was 62.5%, the positive predictive value was 83.8%, the negative predictive value was 76.9%. The accuracy of the combined detection of T2WI and CE T1WI was 90.0%, the sensitivity was 94.1% and the specificity was 81.3%. The positive predictive value The positive predictive value was 91.4%, the negative predictive value was 86.7%. The accuracy of the combined detection of T2WI and DWI was 96.0%. The sensitivity and specificity were 97.1% and 93.8% respectively. The positive predictive value was 97.1% and negative predictive value was 93.8%. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of combined T2WI and DWI were significantly higher than those of other methods (P <0.05). Conclusion T2WI and DWI combined detection can better show the degree of deep myometrial invasion of endometrial cancer, which can provide a reliable basis for clinical diagnosis and improve the diagnostic accuracy.