Application Of Dynamic And Grade Contrast-enhanced3.0T Mr Imaging Unite Diffusion-weighted MR Imaging In Endometrial Carcinoma

Objective To investigate the value of dynamic contrast-enhanced MR imaging for diagnosis of endometrial carcinoma and diffusion-weighted imaging (DWI) for preoperative grading by measuring apparent diffusion coefficient (ADC) values. Materials and methods Fifty-four patients with pathologically confirmed endometrial carcinoma were included in this study. They undergone MR examination with conventional sequence, dynamic contrast-enhanced imaging and DWI (b=0,1000mm2/s). The enhancement pattern, time-intensity curve (TIC) were analyzed. The ADC value of endometrial carcinoma was calculated on ADC maps. The mean ADC value of different pathological grade was compared and the value for pathologically grading was evaluated. Results All MR image could be used for interpretation. Endometrial carcinoma showed slightly progressive enhancement and peaked at60to120seconds. The lesions appeared as hypointensity compared with myometrium. TIC showed slightly washout pattern (n=44) or rapid ascending with long platform (n=15). DEC MR imaging could be used with a sensitivity of86.0%, a specificity of81.3%, an accuracy of84.7%, a positive predictive value of92.5%, a negative predictive value of68.4%for staging la and a sensitivity of88.9%, a specificity of85.7%, an accuracy of84.7%, a positive predictive value of53.3%, a negative predictive value of95.5%for staging Ib and a sensitivity of 75%, a specificity of100%, an accuracy of98.3%, a positive predictive value of100%, a negative predictive value of98.2%for staging Ⅱ and a sensitivity of50%, a specificity of100%, an accuracy of98.3%, a positive predictive value of100%, a negative predictive value of98.3%for staging Ⅲ. DEC MR imaging unite Diffusion-weighted MR imaging could be used with a sensitivity of93.0%, a specificity of93.8%, an accuracy of93.2%, a positive predictive value of97.6%, a negative predictive value of83.3%for staging la and a sensitivity of90.0%, a specificity of91.8%, an accuracy of91.5%, a positive predictive value of69.2%, a negative predictive value of80.4%for staging Ib and a sensitivity of100%, a specificity of100%, an accuracy of100%, a positive predictive value of100%, a negative predictive value of100%for staging II and a sensitivity of50%, a specificity of100%, an accuracy of98.3%, a positive predictive value of100%, a negative predictive value of98.3%for staging Ⅲ. Forty-nine endometrial adenocarcinoma were pathologically confirmed with well-differentiation (n=17), moderate-differentiation (n=31) and poor-differentiation (n=3). There was no significant difference of signal intensity and ADC value of internal obturator internus for three groups (P＞0.05). There was significant difference of ADC value between well-and moderately-differentiated tumors(P＜0.05). However, there was no significant difference of signal intensity between well-and moderately-differentiated tumors (P＞0.05). due to limited number of poorly-differentiated tumors, it was not included in the statistical analysis. Conclusion DCE-MRI would be a useful tool for clinical staging of endometrial carcinoma. DWI could provide useful information of hitopathological differentiation and a negative correlation was found between ADC values and hitopathological grade. DEC and DWI imaging could provide accurate information of clinical staging and tumor grade, which might be helpful for clinical decision.