CAJ | 학술논문

回顾性分析68例子宫内膜癌的磁共振T2加权像(T2WI)和扩散加权成像(DWI)(b=700s/mm2)图像,由2名MR诊断医师采用单纯T2WI与DWI结合T2WI2种方法盲法随机阅片,分析肿瘤肌层浸润深度,以手术病理结果为标准.统计学分析包括Kappa一致性检验,内膜癌肌层浸润的准确度、敏感度、特异度及受试者工作特征曲线(ROC)分析.2名医师对DWI结合T2WI的阅片一致性好(Kappa =0.818),2名医师2种方法判断子宫内膜癌肌层浸润深度的准确度、敏感度及特异度:单纯应用T2WI医师甲为61.8％、60.0％、65.2％,医师乙为66.2％、64.4％、69.6％；DWI结合T2WI医师甲为86.8％、84.4％、91.3％,医师乙为89.7％、86.7％、95.7％.2名医师诊断内膜癌深肌层受浸的ROC曲线下面积(AUC)值分别为0.626与0.879、0.670与0.912,DWI结合T2WI均高于单纯应用T2WI (P＜0.01).3.0 T MR-DWI作为常规T2W]的补充检查序列可以明显提高诊断内膜癌肌层浸润深度的准确性.
회고성분석68례자궁내막암적자공진T2가권상(T2WI)화확산가권성상(DWI)(b=700s/mm2)도상,유2명MR진단의사채용단순T2WI여DWI결합T2WI2충방법맹법수궤열편,분석종류기층침윤심도,이수술병리결과위표준.통계학분석포괄Kappa일치성검험,내막암기층침윤적준학도、민감도、특이도급수시자공작특정곡선(ROC)분석.2명의사대DWI결합T2WI적열편일치성호(Kappa =0.818),2명의사2충방법판단자궁내막암기층침윤심도적준학도、민감도급특이도:단순응용T2WI의사갑위61.8％、60.0％、65.2％,의사을위66.2％、64.4％、69.6％；DWI결합T2WI의사갑위86.8％、84.4％、91.3％,의사을위89.7％、86.7％、95.7％.2명의사진단내막암심기층수침적ROC곡선하면적(AUC)치분별위0.626여0.879、0.670여0.912,DWI결합T2WI균고우단순응용T2WI (P＜0.01).3.0 T MR-DWI작위상규T2W]적보충검사서렬가이명현제고진단내막암기층침윤심도적준학성.
A total of 68 patients with histologically proven endometrial cancer were preoperatively evaluated with a 3.0 T magnetic resonance (MR) unit.Two radiologists interpreted the depth of myometrial invasion on T2-weighted and diffusion-weighted(DW) MR (b =700 s/mm2) imaging.Myometrial tumor spread was classified as superficial (＜ 50％) or deep (≥50％ myometrial thickness).Statistical methods included Kappa statistics for reader agreement,accuracy assessment and receiver operating characteristic analysis for diagnostic performance comparison.For assessing the depth of myometrial invasion,the diagnostic accuracy,sensitivity and specificity were as follows:T2-weighted imaging-reader 1st,61.8％,60.0％ and 65.2％;reader 2nd,66.2％,64.4％ and 69.6％ ; T2-weighted combined DW imaging-reader 1st,86.8％,84.4％and 91.3％ ; reader 2nd,89.7％,86.7％ and 95.7％.Reader agreement was excellent for T2-weighted combined DW imaging (Kappa =0.818).For assessing deep myometrial involvement,ROC analysis showed that the diagnostic accuracy was significantly higher on T2-weighted combined DW imaging than that on T2-weighted imaging.The AUC (area under the curve) values measured by two readers on T2-weighted and T2-weighted combined DW imagings were 0.626,0.879 and 0.670,0.912 respectively.The addition of 3.0T MR diffusion-weighted to T2-weighted imaging can improve the diagnostic performance of MR imaging in the assessment of myometrial invasion.