The Accuracy And Role Of MR Imaging In Clinical Staging Of Endometrial Carcinoma

Objective:To evaluate the accuracy and discuss the role of MRI in preoperative staging of endometrial carcinoma by comparing the preoperative staging with surgicopathologic findings.Methods : Between January 2010 and December 2014, 105 patients with histologically proven primary untreated endometrial carcinoma underwent preoperative assessment with MRI of the pelvis in the first hospital of Dalian medical university were studied in this paper. We retrospectively reviewed the medical records and preoperative MR imaging reports of 105 cases. By compare the MR imaging and the histopathology findings, to evaluate the accuracy of MRI in endometrial carcinoma preoperative staging, and the accuracy, specificity and sensitivity for identifying myometrial invasion, cervical invasion and lymph node metastasis in patients. To evaluate the factors that are associated with the accuracy of MRI for predicting myometrial invasion, and cervical invasion in women with endometrial carcinoma. Kappa test, Chi-square test, Logistic regression were used in this study, and P<0.05 was statistically significant. All date analysed by SPSS 19.0 statistical software.Results:The accuracy of MRI in endometrial carcinoma preoperative staging in stage â… A, stage â… B, stage â…¡, stage â…¢A and stage â…¢C were 86.7%, 86.7%, 93.3%, 99%, 96.2%, and the overall accuracy was 81%. The results of consistency checking between preoperative MRI staging and surgico-pathologic findings as follows:K=0.610,P<0.05(P=0.000). And the results were statistically significant between groups. The sensitivity, specificity and accuracy for identifying any myometrial invasion(superficiall or deep) were 84.3%, 93.8% and 85.7% respectively; these values for deep myometrial invasion were 55.2%, 92.1% and 81.9%, respectively. The sensitivity, specificity and accuracy of MRI for detecting cervical invasion were 77.8%, 100% and 96.2%, respectively. The sensitivity, specificity and accuracy of MRI for lymph node metastasis were 75%, 97.9% and 96.2%, respectively. The results of consistency checking with surgico-pathologic findings were 0.585, 0.511, 0.853 and 0.729, respectively(P<0.05 respectively). The patients who had adenomyosis more frequently had incorrect prediction of any myometrial invasion(superficial or deep)(P=0.020). The patients who were older than 60, postmenopause, and postmenopause more than 5 years were associated with a more incorrect prediction of deep myometrial invasion(P=0.000, P=0.030, P=0.000, respectively). The logistic regression(Backward: Wald)among these factors showed postmenopause more than 5 years was the independent factors associated with incorrect prediction of deep myometrial invasion(B=2.565,P=0.001).Conclusion:1. For the high consistency with surgico-pathologic findings, there was a high clinical value of MRI in endometrial carcinoma preoperative staging.2.Adenomyosis was statistical associated with incorrect prediction of any myometrial invasion. Postmenopause more than 5 years was the independent factors associated with incorrect prediction of deep myometrial invasion.