CAJ | 학술논문

目的：探讨FLASH-3D动态增强技术在子宫内膜癌检查中的应用价值及术前分期中的作用。方法前瞻性的对2012年10月-2013年04月间具有完整临床资料及病理组织学证实的子宫内膜癌患者48例，在术前常规MRI检查的基础上，行FLASH-3D动态增强MRI扫描，分析宫壁及肿瘤的MRI动态增强特点，采用双盲法，将FLASH-3D动态增强对子宫内膜癌分期及判断肌层浸润深度的结果，与术后病理组织学FIGO结果对照。结果本组48例中，Ⅰ期34例(Ia22例，Ib12例)，Ⅱ期9例，Ⅲ期3例，Ⅳ期2例。FLASH-3D动态增强序列分期准确性为81%(39/48)，正确判断深肌层侵犯的敏感性为84%、特异性为90%、准确性为88%、与术后病理组织学结果对照，差异无显著意义(P＞0.05)。结论 FLASH-3D动态增强技术在子宫内膜癌早期诊断和术前分期中具有重要作用，能显著提高判断肿瘤肌层浸润深度的准确性，为临床手术方式的选择和术后评估具有指导作用，有望成为女性盆腔肿瘤的常规检查方法。
목적：탐토FLASH-3D동태증강기술재자궁내막암검사중적응용개치급술전분기중적작용。방법전첨성적대2012년10월-2013년04월간구유완정림상자료급병리조직학증실적자궁내막암환자48례，재술전상규MRI검사적기출상，행FLASH-3D동태증강MRI소묘，분석궁벽급종류적MRI동태증강특점，채용쌍맹법，장FLASH-3D동태증강대자궁내막암분기급판단기층침윤심도적결과，여술후병리조직학FIGO결과대조。결과본조48례중，Ⅰ기34례(Ia22례，Ib12례)，Ⅱ기9례，Ⅲ기3례，Ⅳ기2례。FLASH-3D동태증강서렬분기준학성위81%(39/48)，정학판단심기층침범적민감성위84%、특이성위90%、준학성위88%、여술후병리조직학결과대조，차이무현저의의(P＞0.05)。결론 FLASH-3D동태증강기술재자궁내막암조기진단화술전분기중구유중요작용，능현저제고판단종류기층침윤심도적준학성，위림상수술방식적선택화술후평고구유지도작용，유망성위녀성분강종류적상규검사방법。
Objective To investigate the application value and preoperative staging role of FLASH-3D dynamic contrast-enhanced technique in examination of endometrial carcinoma. Methods From October 2012 to April 2013, the prospective study included 48 patients with complete clinical data and pathologically confirmed endometrial carcinoma. After routine MRI examination, the subjects were underwent FLASH-3D (a fast low angle shot technique with three dimensional fat-suppressed angiographic sequences) dynamic contrast-enhanced examination. The dynamic enhancement features of uterine wall and tumors were analyzed respectively. With a double-blind manner,FLASH-3D preoperative staging and findings in assessing myometrial invasion were compared with the postoperative pathological results. Results 48 cases with pathologically-proven endometrial carcinoma were composed of 34 patients in stage I(Ia 22 cases、Ib 12 cases), 9 cases in stage II, 3 cases in stage III, 2 cases in stage IV. The staging accuracy for endometrial carcinoma was 81%(39/48) by using FLASH-3D dynamic contrast-enhanced sequence. In the determining of deep myometrial invasion, the sensitivity, specificity and accuracy were 84%、90%、88% respectively. There were no significant difference compared with the postoperative results of pathology(p>0.05). Conclusion FLASH-3D dynamic contrast-enhanced technique is valuable for early diagnosis of endometrial carcinoma and assessing preoperative staging. The high accuracy for assessing deep myometria1 invasion achieved makes FLASH-3D sequence as an important examination method in selecting the optimal therapeutic protoco1 and prognosis estimation.