Myometrial invasion and overall staging of endometrial carcinoma: assessment using fusion of T2-weighted magnetic resonance imaging and diffusion-weighted magnetic resonance imaging.
Myometrial invasion and overall staging of endometrial carcinoma: assessment using fusion of T2-weighted magnetic resonance imaging and diffusion-weighted magnetic resonance imaging.
复制标题
子宫内膜癌的肌层浸润和总体分期：T2加权磁共振成像和扩散加权磁共振成像融合评估
DOI：
10.2147/ott.s145763
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发表时间：
2017
影响因子：
4
通讯作者：
Guo Z
中科院分区：
文献类型：
--
作者：
Guo Y;Wang P;Wang P;Gao W;Li F;Yang X;Ni H;Shen W;Guo Z
背景近年来，子宫内膜癌的发病年龄呈下降趋势。在子宫内膜癌中，准确评估浸润深度和术前分期非常重要。T2加权成像（T2 WI）和弥散加权成像（DWI）的融合可能有助于改善病变的解剖定位。材料与方法58例子宫内膜癌患者均经病理证实。根据2009年修订的国际妇产科联合会分期系统，融合T2 WI和DWI用于评估浸润深度和确定总体分期。以术后病理评估为参考标准。采用Kappa统计分析T2 WI图像分期与病理分期的一致性，T2 WI与DWI融合图像分期与病理分期的一致性。结果T2 WI与DWI融合对子宫肌层浸润的诊断准确率明显高于T2 WI组（T2 WI为77.6%，T2 WI-DWI为94.8%）。对于深部浸润的识别，我们计算了诊断敏感性（T2 WI为69.2%; T2 WI-DWI为92.3%）、特异性（T2 WI为80%; T2 WI-DWI为95.6%）、阳性预测值（T2 WI为50%; T2 WI-DWI为85.7%）和阴性预测值（T2 WI为90%; T2 WI-DWI为97.7%）。总之，T2 WI-DWI融合在分期方面的诊断准确性高于仅T2 WI（T2 WI为81.0%; T2 WI-DWI为94.8%）。结论T2 WI-DWI融合成像可作为一种无创、低成本的方法，有效地评估子宫内膜癌肌层浸润程度及分期。
Background The age of onset of endometrial carcinoma has been decreasing in recent years. In endometrial carcinoma, it is important to accurately assess invasion depth and preoperative staging. Fusion of T2-weighted magnetic resonance imaging (T2WI) and diffusion-weighted magnetic resonance imaging (DWI) may contribute to the improvement of anatomical localization of lesions. Materials and methods In our study, a total of 58 endometrial carcinoma cases were included. Based on the revised 2009 International Federation of Gynecology and Obstetrics staging system, a fusion of T2WI and DWI was utilized for the evaluation of invasion depth and determination of the overall stage. Postoperative pathologic assessment was considered as the reference standard. The consistency of T2WI image staging and pathologic staging, and the consistency of fused T2WI and DWI and pathologic staging were all analyzed using Kappa statistics. Results Compared with the T2WI group, a significantly higher diagnostic accuracy was observed for myometrial invasion with fusion of T2WI and DWI (77.6% for T2WI; 94.8% for T2WI-DWI). For the identification of deep invasion, we calculated values for diagnostic sensitivity (69.2% for T2WI; 92.3% for T2WI-DWI), specificity (80% for T2WI; 95.6% for T2WI-DWI), positive predictive value (50% for T2WI; 85.7% for T2WI-DWI), and negative predictive value (90% for T2WI; 97.7% for T2WI-DWI). In summary, T2WI-DWI fusion exhibits higher diagnostic accuracy with respect to staging relative to T2WI only (81.0% for T2WI; 94.8% for T2WI-DWI). Conclusion Fused T2WI-DWI may represent a noninvasive, lower cost approach for the effective assessment of myometrial invasion and staging of endometrial carcinoma.