Study On The Value And Influencing Factors Of Multimodal MRI In The Diagnosis Of Endometrial Carcinoma Staging

Endometrial carcinoma is a common malignant tumor of female genital tract,and it often occurs in postmenopausal women.In China,its incidence is only inferior to cervical cancer,which poses a serious threat to the life and health of women.MRI has a distinct advantage in the diagnosis of endometrial cancer.The examination has the characteristics of no trauma,higher soft tissue resolution and multiple sequence imaging.It can show the anatomical structure of pelvis and uterus clearly,and also can evaluate the nature and extent of tumor accurately.It has been widely regarded as the best imaging method for diagnosis and staging of endometrial carcinoma.In this article,we retrospectively analyzed the performance in 120 cases of endometrial cancer patients undergoing multimodal MRI,by comparing with postoperative pathological diagnosis.We also discussed the value of multimodal MRI in the diagnosis of endometrial carcinoma staging,and explored the related factors that might influence the accuracy of multi-modal MRI.Objective:To explore the value of multimodal MRI in the diagnosis of endometrial carcinoma and to analyze the factors which affect the accuracy of the diagnosis.Materials and methods:We collected 120 cases of endometrial cancer confirmed by surgery and pathology from October 2012 to December 2017 in The First Affiliated Hospital of Soochow University and Wuxi Fourth People's Hospital.All patients underwent pelvic MRI examination(include Diffusion Weighted Imaging sequence(DWI)and dynamic enhanced scanning sequence(DCE))within 1 week before operation.The postoperative pathological staging was used as the gold standard to evaluate the diagnostic value of multi-modal MRI in preoperative staging of endometrial carcinoma,and to explore the factors influencing the accuracy of multimodal MRI.Results:The accuracy rate of diagnosing endometrial carcinoma staging:A mode(T1WI+T2WI)is73.3%;Bmode(T1WI+T2WI+DWI)is80%;C mode(T1WI+T2WI+DWI+DCE-MRI)is 89.17%.There was a statistically significant difference in the overall accuracy rate among C,A and B mode in the stage of endometrial cancer(x ~2,=9.87,3.87,P=0.01,0.04).The results showed that the false positive rate was significantly higher in patients with hyper differentiation of uterine cavity than those in another group,which was significantly correlated with the misclassification rate(chi square was 19.11,15.98,P<0.01).Multivariate Logistic regression analysis showed that low tissue differentiation was an independent factor influencing the accuracy rate of C mode MRI in the stage of endometrial cancer(B=3.104,P=0.009,OR=22.289).Conclusion:Multimodal MRI can improve the accuracy of the diagnosis of endometrial carcinoma,and have a high consistency with the results of postoperative pathological staging.Tissue low differentiation is an important factor of influencing the accuracy of endometrial carcinoma in multimodal MRI.