超声、CT和MRI在子宫内膜癌术前分期诊断中的价值分析-影像医学与核医学专业论文.docxVIP

新疆医科大学硕士学位论文 新疆医科大学硕士学位论文 1 1 超声、CT 和 MRI 在子宫内膜癌术前分期 诊断中的价值分析 研究生：孙艳 导师：马富成 摘 要 目的：探讨子宫内膜癌病例术前超声、CT 和 MRI 检查对分期的应用价值。方 法：回顾性分析 170 例经手术病理证实的子宫内膜癌的临床病例，170 例均经超声检 查，其中 92 例经 CT 检查，78 例经 MRI 检查，应用 SPSS17.0 软件对患者术前影像 检查结果与术后病理分期进行一致性检验，并对三种影像学手段在子宫内膜癌术前 分期中Ⅰ期的诊断灵敏度、特异度，阳性预测值，阴性预测值进行研究。结果：92 例均经超声、CT 检查的病例中，超声、CT 与术后病理分期进行一致性检验，k 值分 别为 0.4516,0.3253，78 例均经超声、MRI 检查的病例中，超声、MRI 与术后病理分 期进行一致性检验，k 值分别为 0.4599，0.2923。超声对Ⅰ期子宫内膜癌的诊断的灵 敏度、特异度，阳性预测值，阴性预测值分别为 79.8%、65.2%、86.1%、54.5%， CT 对Ⅰ期子宫内膜癌的诊断的灵敏度、特异度，阳性预测值，阴性预测值分别为 89.8%、 42.4%、73.6%、70.0%， MRI 对Ⅰ期子宫内膜癌的诊断的灵敏度、特异度，阳性预 测值，阴性预测值分别为 90.0%、50.0%、85.7%、60.0%。子宫内膜癌淋巴结转移时 超声、CT 和 MRI 均无明显优势。结论：超声对于子宫内膜癌的分期诊断具有中等 价值，可作为子宫内膜癌分期诊断的首选影像学方法之一，对于子宫内膜癌粘膜层 的侵犯及淋巴结的转移 CT 和 MRI 均未显示明显优势。 关键词：子宫内膜癌；诊断；超声； CT；MRI 2 2 Value of the ultrasound CT and MRI in Pre-operative Staging of uterine endometrial carcinoma Postgraduate：Sun Yan Tutor：Pro.Ma Fucheng Abstract Objective:To evaluate the role of ultrasound?CT and MRI in uterine endometrial carcinoma preoperative staging.Methods:170 cases of pathologically confirmed uterine endometrial carcinoma were studied retrospectively to assess the staging capability by ultrasound ?CT and MRI .All patients underwent ultrasound examination ,92 patients undernwent CT eamination and 78 underwent MRI examination.The agreement of ultrasound ? CT and MRI,compared with the results of pathology.The sensitivity ? specificity? pos.predictive value and neg.predictive value of ultrasound ?CT and MRI of uterine endometrial carcinoma preoperative staging Ⅰwere analyzed ,respectively. Resullts:The agreement of ultrasound and CT in 92 patients was 0.4516,0.3253, respectively. The agreement of ultrasound and MRI in 78 patients was 0.4599,0.2923, respectively. The sensitivity?specificity? pos.predictive value and neg.predictive value of ultrasound ?CT and MRI of uterine endometrial carcinoma preoperative staging Ⅰwere 79.8%?65.2%?86.1%?54.5%,89.8%?42.4%?73.6%?70.0%,and 90.0% ?50.0%?85.7%? 60.0%,respectively.Conclusion