The Diagnostic Value Of MRI In Endometrial Carcinoma

Objective:Endometrial carcinoma is one of the most common gynecologic malignancies,which seriously affects the physical and mental health of the women.Although the operative pathology stage of the Federation International of Gynaecology and Obstetrics has been established,endometrial cancer should undergo staging operation system,but preoperative imaging examination is conducive to the best treatment planning.At present,such as transvaginal ultrasonography,computed tomography(CT),magnetic resonance imaging(MRI),several common imaging technologies have been used as diagnostic tools for preoperative staging of endometrial carcinoma.It is multidimensional and multiplanar and is the Ideal imaging with high resolution to soft tissue,so it have been used more and more frequently in the preoperative staging diagnosis of endometrial carcinoma.The purpose of this study was to explore the diagnostic value of MRI for endometrial carcinoma and to evaluate the accuracy of MRI in the diagnosis of endometrial carcinoma.Materials and methods:Endometrial cancer was diagnosed in a total of 378 patients by preoperative endometrial curettage,preoperative MRI,and all of them underwent staging operation from January 2015 to December 2016 in Obstetrics and Gynecology Department of the Second hospital of Jilin University.All data were statistically analyzed by SPSS21.0 software.The preoperative diagnostic staging diagnosed by MRI and postoperative pathological staging of endometrial carcinoma were compared,and the accuracy of MRI in preoperative staging diagnosis of endometrial carcinoma was calculated.The data of the myometrium infiltration,cervical infiltration and lymph node metastasis detected by MRI were compared by Kappa consistency check with the postoperative pathological results.Results:1,The diagnostic accuracy of MRI for the preoperative staging of endometrial carcinoma was 74.8% with the reference standard of postoperative pathological results.2,The results of myometrium infiltration diagnosed by MRI were compared by Kappa consistency check with the postoperative pathological results,and the Kappa value was 0.495 and P < 0.001.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy for myometrial invasion on MRI were 78.6%,88%,44%,97.2% and 87%,respectively.3,The results of cervical infiltration diagnosed by MRI were compared by Kappa consistency check with the postoperative pathological results,and the Kappa value was 0.440,and P < 0.001.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy for cervical invasion on MRI were 47.4%,93.8%,56.3%,91.3% and 87%,respectively.4,The results of lymph node metastasis diagnosed by MRI were compared by Kappa consistency check with the postoperative pathological results,and the Kappa value was 0.131 and P < 0.001.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy for lymph node metastasis on MRI were 50%,92.2%,9%,99.2%,and 91.6%,respectively.Conclusion:MRI has high accuracy and negative predictive rate in the preoperative staging diagnosis of endometrial cancer.It is an accurate method to evaluate the preoperative staging diagnosis of endometrial carcinoma,which can significantly improve the rate of preoperative staging of endometrial carcinoma.