Role of Magnetic Resonance Imaging in distinguishing the origin of adenocarcinoma at the junction of the lower uterine segment and endocervix
10.3760/cma.j.issn.0253-3766.2018.12.008
- VernacularTitle: 磁共振成像对宫体宫颈交界处腺癌的诊断价值
- Author:
Jie ZHANG
1
;
Yichen WANG
1
;
Xiaoduo YU
1
;
Yuan TIAN
1
;
Xiaolu LI
1
;
Lianyu ZHANG
1
;
Jin ZHANG
1
;
Xinming ZHAO
1
;
Yan CHEN
1
Author Information
1. Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 100021
- Publication Type:Clinical Trail
- Keywords:
Magnetic resonance imaging;
Cervical neoplasms;
Endometrial neoplasm;
Adenocarcinoma
- From:
Chinese Journal of Oncology
2018;40(12):912-916
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate Magnetic Resonance Imaging (MRI) at 3.0T in differential diagnosis of the origin of adenocarcinoma at the junction of the lower uterine segment and endocervix.
Methods:71 patients with adenocarcinoma at the junction of the lower uterine segment and endocervix were retrospectively collected. Pelvic MR examinations, including diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) sequences, were performed within 2 weeks before surgery. MR images were analyzed and measured by two radiologists, including the location of the tumor center, the enhancement pattern, the anterior and posterior diameters, the left and right diameters, the upper and lower diameters, and the apparent diffusion coefficient (ADC) of the tumor. Immunohistochemical method was used as gold standard in distinguishing cervical adenocarcinoma and uterine adenocarcinoma.
Results:The upper and lower diameters of uterine adenocarcinoma were [(5.80±2.31) cm], significantly larger than those of cervical adenocarcinoma [(4.16±2.17) cm, P=0.009]. Using 4.5cm as the best cutoff point value, the sensitivity and specificity in distinguishing uterine adenocarcinoma and cervical adenocarcinoma were 68.4% and 65.4%, respectively. According to the location of tumor center, the sensitivity and specificity were 84.2% and 73.1%, respectively. Using tumor enhancement pattern as the criterion, the sensitivity and specificity of diagnosing uterine adenocarcinoma and cervical adenocarcinoma were 68.4% and 80.8% respectively.
Conclusions:MRI has certain clinical value in evaluating the origin of adenocarcinoma at the junction of the lower uterine segment and endocervix. The lesions can be diagnosed according to the main location, the characteristics of dynamic enhancement and the growth pattern of the tumor.
