1.Diagnostic value of dynamic contrast-enhanced MRI in the staging of endometrial cancer
Ting ZHANG ; Ailian LIU ; Meiyu SUN ; Heqing WANG ; Ping PAN ; Jinzi XING ; Qingwei SONG
Chinese Journal of Radiology 2013;47(10):898-902
Objective To explore the relationship between the characteristics of dynamic contrastenhanced MRI (DCE-MRI) and the stages of endometrial cancer.Methods A retrospective analysis of DCE-MRI manifestation in 55 patients with scratch-pathologically confirmed endometrial cancer was performed.All patients were divided into different groups according to differentiation,muscle layer infiltration,cervix involvement and metastasis.The enhanced rate,including the arterial phase relative signal increase ratio (ARSI%),the maximal relative signal increase ratio (MRSI%) and the signal enhancement ratio (SER%),was calculated at different time (i.e.16 s,32 s,48 s,64 s and 300 s),respectively.Time-intensity curves (TIC) of lesions were also obtained and divided into 4 subtypes.Two sample t test was performed to compare the MRSI% among groups,and the Mann-Whitney U test was performed in ARSI% and SER% as well.Results The early phase enhanced rate of normal tissue was 894 ± 355,higher than that of tumor 716 ± 215 (t =-2.911,P < 0.01).The delayed phase enhanced rate of normal tissue was 1111 ± 289,higher than that of tumor 803-± 289 (t =-4.926,P < 0.01).ARSI% of low differentiation group (n =16,M =1.07%) was higher than that of middle to high differentiation group (n =39,M=0.36%).ARSI% of deep muscle layer infiltration group (n =19,M =0.76%) was higher than that of no muscle layer infiltration group (n =36,M =0.32%).ARSI% of cervix involvement group (n =27,M =0.84%) was higher than that of no cervix involvement group (n =28,M =0.25%).SER% of cervix involvement group (n =27,M =2.90%) was higher than that of no involvement group (n =28,M =1.40%) and SER% of parauterine involvement and metastasis group (n =7,M =2.03%) was higher than that of uterine involvement group (n =48,M =1.60%).The differences between these groups were statistically significant (Z =-2.038,-2.260,-2.172,-2.695 and-2.621 respectively,P < 0.05).Based on the TIC types,type Ⅰ occurred in 13 tumors (23.6%),type Ⅱ in 22 tumors (40%),type Ⅲ in 9 tumors (16.4%),and type Ⅳ in 11 tumors (20%).Conclusions Based on TIC curves,most of endometrial cancers showed significant enhancement which reflected of their rich blood supply.The parameters of DCE-MRI is helpful in staging of uterus tumors.