Effect of Doppler ultrasound, CT and MRI in preoperative staging diagnosis of endometrial cancer
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摘要:
目的 探讨多普勒超声、CT及MRI在子宫内膜癌患者术前分期诊断中的应用价值，为临床诊断方法更新提供佐证依据。 方法 选取湖州市妇幼保健院2019年12月—2021年12月收治的98例经术后病理检查确诊为子宫内膜癌的患者为研究对象，所有患者术前均行多普勒超声、CT及MRI检查，收集3种检查报告结果，分析比较3种检查对术前分期的诊断效果。 结果 术后病理检查显示，98例患者均为内膜样腺瘤，其中Ⅰ期61例，Ⅱ期6例，Ⅲ期21例，Ⅳ期10例；98例患者术前多普勒超声、CT及MRI检查诊断分期分别为Ⅰ期38例、56例、60例，Ⅱ期5例、3例、4例，Ⅲ期15例、15例、18例，Ⅳ期8例、5例、8例；将术后病理检查结果作为金标准，术前多普勒超声、CT及MRI检查诊断子宫内膜癌患者术前分期的准确率分别为67.35%(66/98)、80.61%(79/98)、91.84%(90/98)；ROC曲线分析显示3种术前检查对分期的诊断均具有较高的临床价值(AUC值分别为0.582、0.653、0.676，均P＜0.05), 其中MRI术前诊断分期的临床价值最高。 结论 多普勒超声、CT及MRI均可作为子宫内膜癌患者术前分期诊断的影像学检查方法，能够为临床医师诊断提供有力的依据，且MRI术前诊断分期的准确率高于多普勒超声和CT，在临床条件允许的情况下可以优先选择。 Abstract:Objective To investigate the application value of Doppler ultrasound, CT and MRI in the preoperative staging diagnosis of endometrial cancer, and to provide evidence for updating of clinical diagnostic methods. Methods From December 2019 to December 2021, 98 patients with endometrial cancer diagnosed by postoperative pathological examination in Huzhou maternal and child health hospital were retrospectively analyzed. All patients were examined by Doppler ultrasound, CT and MRI before surgery, and the results of the three examination reports were collected, and the diagnostic effect of their preoperative staging was analyzed and compared. Results Postoperative pathological analysis showed that 98 patients were all endometrioid adenomas, and the postoperative pathological stages were as follows: 61 cases in stage Ⅰ, 6 cases in stage Ⅱ, 21 cases in stage Ⅲ, and 10 cases in stage Ⅳ. The preoperative diagnostic stages of the 98 patients were reported as follows: Stage Ⅰ, 38 cases, 56 cases, 60 cases; Stage Ⅱ, 5 cases, 3 cases, 4 cases; Stage Ⅲ, 15 cases, 15 cases, 18 cases; Stage Ⅳ, 8 cases, 5 cases, 8 cases; Taking the results of postoperative pathological examination as the gold standard, the accuracy rates of preoperative Doppler ultrasound, CT and MRI for the preoperative staging of patients with endometrial cancer are 67.35% (66/98), 80.61% (79/98), 91.84% (90/98); ROC curve analysis showed that the results of the three preoperative examination stages had high clinical value on the pathological examination results (AUC values were 0.582, 0.653, 0.676 respectively, all P < 0.05), among which the comprehensive accuracy rate of MRI preoperative diagnosis stage was the highest in clinical value. Conclusion Doppler ultrasound, CT and MRI can be used as imaging modalities for preoperative staging of endometrial cancer patients, which can provide a strong basis for clinicians diagnosis of clinicians. However, the overall accuracy of preoperative diagnosis and staging of MRI for is significantly higher than that of Doppler ultrasound and CT, which may be preferred when clinical conditions allow. -
Key words:
- Doppler ultrasound /
- CT /
- MRI /
- Endometrial cancer /
- Preoperative staging /
- The effect
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图 1 3种术前检查在子宫内膜癌分期诊断中的ROC曲线
Figure 1. ROC curves of three preoperative tests for staging diagnosis in endometrial cancer
表 1 子宫内膜癌患者多普勒超声术前检查分期结果与病理检查结果比较(例)
Table 1. Comparison of preoperative staging and pathological results of endometrial carcinoma patients using Doppler ultrasound(cases)
多普勒超声 病理检查 合计 Ⅰ期 Ⅱ期 Ⅲ期 Ⅳ期 Ⅰ期 38 0 0 0 38 Ⅱ期 12 5 2 2 21 Ⅲ期 8 0 15 0 23 Ⅳ期 3 1 4 8 16 合计 61 6 21 10 98 
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表 2 子宫内膜癌患者CT术前检查分期结果与病理检查结果比较(例)
Table 2. Comparison of preoperative CT staging and pathological findings in patients with endometrial carcinoma (cases)
CT 病理检查 合计 Ⅰ期 Ⅱ期 Ⅲ期 Ⅳ期 Ⅰ期 56 0 0 0 56 Ⅱ期 0 3 3 5 11 Ⅲ期 0 3 15 0 18 Ⅳ期 5 0 3 5 13 合计 61 6 21 10 98
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表 3 子宫内膜癌患者MRI术前检查分期结果与病理检查结果比较(例)
Table 3. Comparison of preoperative MRI staging results and pathological findings in patients with endometrial cancer (cases)
MRI 病理检查 合计 Ⅰ期 Ⅱ期 Ⅲ期 Ⅳ期 Ⅰ期 60 0 0 0 60 Ⅱ期 0 4 0 2 6 Ⅲ期 0 2 18 0 20 Ⅳ期 1 0 3 8 12 合计 61 6 21 10 98
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