Subendometrial enhancement and peritumoral enhancement for assessing endometrial cancer on dynamic contrast enhanced MR imaging.
Eur J Radiol
; 84(4): 581-9, 2015 Apr.
Article
em En
| MEDLINE
| ID: mdl-25636389
ABSTRACT
OBJECTIVES:
To evaluate the diagnostic accuracy of subendometrial enhancement (SEE) in assessing the myometrial invasion in endometrial cancer, the frequency and clinical significance of peritumoral enhancement (PTE) on dynamic contrast enhanced (DCE) imaging. MATERIALS ANDMETHODS:
MR images of 147 patients with endometrial cancer were retrospectively analyzed for intact SEE and PTEs Type 1, a focal early enhancement peritumorally, and Type 2, an irregular thin-layered early intense enhancement peritumorally. Two radiologists independently assessed intact SEE and PTEs on DCE imaging and compared the lesions by the presence and depth of myometrial invasion, grade, lymphovascular space involvement (LVSI), and lymph node metastasis. The relationship between SEE, PTEs, and each factor was analyzed using univariate and multivariate analyses. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for SEE.RESULTS:
The sensitivity, specificity, PPV, NPV and diagnostic accuracy for myometrial invasion based on SEE disruption on DCE were 96.6%, 32.1-46.4%, 85.8-88.5%, 69.2-76.5%, and 84.4-87.1%. According to multivariate analysis, SEE significantly predicted myometrial invasion (p<0.0001). PTE Type 2 significantly predicted myometrial invasion presence (p<0.05) and depth (p<0.01).CONCLUSION:
Diagnosis of myometrial invasion only by using SEE might be difficult on DCE-MRI due to the overestimation by strong focal enhancement of PTE Type 1. PTE Type 2 correlates both with the presence and depth of myometrial invasion and also may play an important role in the diagnosis of LVSI.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Endométrio
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Imagem de Difusão por Ressonância Magnética
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Miométrio
Tipo de estudo:
Diagnostic_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Eur J Radiol
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Japão