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目的分析FIGO Ⅰ期和Ⅱ期子宫内膜癌的MRI表现,评价MRI对子宫内膜癌肌层和宫颈侵犯的价值。方法回顾性分析30例经手术病理证实的Ⅰ期和Ⅱ期子宫内膜癌T1WI、T2WI和动态增强图像,观察肿瘤的类型、信号、强化特点及结合带与内膜下强化的显示情况,将MRI判断肌层和宫颈侵犯的结果与病理比较。结果弥漫型子宫内膜癌14例,表现为子宫内膜广泛增厚。局灶型子宫内膜癌16例,表现为宫腔内息肉状病灶或较大的肿块。 T1WI多为等信号,T2WI多为高信号。动态增强早期13例弥漫型子宫内膜癌呈轻至中度强化,15个局灶型肿瘤呈明显或中度强化。T2WI显示结合带18例,动态增强图像显示内膜下强化17例。MRI判断深肌层侵犯的敏感度、特异度和准确率分别为87．5％、 95．5%和93．3％,判断宫颈侵犯的敏感度、特异度和准确率分别为75％、95．5％和90%。结论 MRI评价子宫内膜癌肌层和宫颈侵犯是准确可靠的,应列为术前常规检查。
Objective To analyze the MRI findings of FIGO stage Ⅰ and Ⅱ endometrial carcinoma and evaluate the value of MRI in the invasion of endometrial carcinoma and cervix. Methods A retrospective analysis of 30 patients with pathologically confirmed Ⅰ and Ⅱ of endometrial cancer T1WI, T2WI and dynamic enhanced image, the type of tumor was observed, the signal, strengthening the case of displaying enhanced binding characteristics and the band and the endometrium, the MRI to determine the results of myometrial and cervical invasion and pathological comparison. Results diffuse endometrial carcinoma in 14 cases, the performance of extensive endometrial thickening. Focal endometrial cancer in 16 cases, showed intrauterine polypoid lesions or larger lumps. T1WI mostly equal signal, T2WI mostly high signal. Dynamic enhancement Early diffuse endometrial carcinoma in 13 cases was mild to moderate enhancement, 15 focal tumors were significantly or moderately enhanced. T2WI showed a band of 18 cases, dynamic enhanced images showed enhancement of the intima in 17 cases. The sensitivity, specificity and accuracy of MRI in determining deep muscle invasion were 87.5%, 95.5% and 93.3% respectively. The sensitivity, specificity and accuracy of cervical invasion were 75%, 95% .5% and 90%. Conclusion The MRI evaluation of myometrial and cervical invasion of endometrial cancer is accurate and reliable and should be listed as routine preoperative examination.