弥散加权成像评价子宫内膜癌盆腔淋巴结转移的准确性。

Pub Date : 2023-07-01 DOI:10.29271/jcpsp.2023.07.738
Imrana Masroor, Shaista Afzal, Hina Pathan
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引用次数: 0

摘要

目的:以组织病理学为金标准,评价弥散加权成像对子宫内膜癌患者盆腔淋巴结转移的敏感性和特异性,并与MRI增强序列的准确性进行比较。研究设计:回顾性研究。研究地点和时间:2021年1月至12月,卡拉奇阿加汗大学医院放射科。方法:采用方便抽样的方法,纳入活检证实子宫内膜癌并有完整病历的成年女性58例。没有完整医疗记录的患者被排除在外。研究变量包括淋巴结信号特征及其短轴直径。以组织病理学为金标准,计算DWI和增强MRI对病变淋巴结的敏感性和特异性。结果:58例经组织病理学证实的子宫内膜癌患者中,14例有转移性淋巴结病。dwi加权成像对转移性和非转移性淋巴结的敏感性为81.1%,特异性为88.8%、72.2%和82.5%,增强成像的阳性预测值和阴性预测值分别为66.6%、58.1%、35.7%和83.3%。结论:DWI对子宫内膜癌患者病变淋巴结的评估和鉴别转移性和非转移性淋巴结的准确性优于MRI增强检查。关键词:DWI,增强MRI,淋巴结,子宫内膜癌。
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Accuracy of Diffusion Weighted Imaging in Assessment of Pelvic Lymphnode Metastasis in Patients with Endometrial Cancer.

Objective: To evaluate the sensitivity and specificity of diffusion-weighted imaging in determining metastatic pelvic lymph nodes in patients of endometrial cancer and comparing its accuracy with contrast-enhanced sequence of MRI, taking histopathology as gold standard.

Study design: Retrospective Study. Place and Duration of the Study: Department of Radiology, the Aga Khan University Hospital Karachi, from January to December 2021.

Methodology: Fifty-eight adult females with biopsy proven endometrial carcinoma and complete medical records were included through convenience sampling. Patients who did not have complete medical records were excluded. Studied variables included signal characteristics of lymph nodes and their short axis diameter. The sensitivity and specificity of DWI and contrast-enhanced MRI for evaluation of diseased lymph nodes were calculated using histopathology as the gold standard.

Results: Among 58 patients with histopathologically proven endometrial cancer, 14 had metastatic lymphadenopathy. DWI-weighted imaging in the evaluation of metastatic and non-metastatic lymph nodes had sensitivity of 81.1% while specificity, the positive and negative predictive value of 88.8%, 72.2%, and 82.5% and on contrast-enhanced imaging as 66.6%, 58.1%, 35.7%, and 83.3%, respectively.

Conclusion: The DWI shows better accuracy in evaluation and discrimination between metastatic and non-metastatic lymph nodes as compared to contrast-enhanced MRI examination for the evaluation of diseased lymph nodes in patients with endometrial cancer.

Key words: DWI, Contrast-enhanced MRI, Lymph node, Endometrial cancer.

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