The Research About Diagnostic Value Of Preoperative Classification By Transvaginal Sonography Contrast-enhanced Ultrasonography And MRI Enhancement In ? Stage Endometrial Carcinoma

Objective: To explore the preoperative classification diagnosis value of Transvaginal Sonography Contrast-enhanced Ultrasonography(TVS-CEUS)and MRI(Magnetic Resonance Imaging)enhancement on stage I endometrial carcinoma.Methods: 84 patients who had been diagnosed by postoperative pathological as stage I endometrial carcinoma were selected for retrospective analysis.These 84 patients had accepted TVS-CEUS and MRI enhancement for inspection before operative.Comparing the preoperative staging diagnosis and the postoperative pathological stage results,we can explore the diagnostic value of two imaging examination inspection methods.Endometrial carcinoma lesions and normal uterine myometrium were selected as the regions of interest in TVS-CEUS inspection.Time-intensity curve(TIC)was drawn to gain two sets parameters.The curve quantitative parameters were used to analyze endometrial carcinoma lesions and the features of micro-circulation infusion of normal muscular layer in uterus.To draw the ROC curve,comparing the area under the curve(AUC)to evaluated the diagnosis of two imaging diagnosis methods.Results: In 84 patients who had been diagnosed by postoperative pathological,50 patients were in stage IA and 34 patients were in stage IB.With TVS-CEUS and MRI enhancement respectively,7 patients and 5 patients,who were diagnosed as stage IA by postoperative pathological diagnosis,were over-diagnosed as stage IB;6 patients and 5 patients who were diagnosed as stage IB were underestimated as stage IA.The sensibility,specificity,positive predictive value,negative predictive and coincidence rate of preoperative diagnosis of endometrial cancer in stage I through TVS-CEUS and MRI were(86.00%?82.35%?87.75%?80.00%?84.52%)?(90.00%?85.29%?90.00%?85.29%?88.10%).By making a comparison of TVS-CEUS TIC curve in endometrium focus and normal muscular layer,we can find that the rates of the AT,the TTP and the ET in endometrium focus were less than the normal muscular layer and the PI value in endometrium focus was higher than the normal muscular layer.There was the statistical significance in these differences(P<0.001).Interpretation of ROC curve: the areas under the TVS-CEUS and MRI enhancement preoperative diagnosis curves were0.842 and 0.876.Conclusion: TVS-CEUS and MRI enhancement have high diagnostic value in evaluating preoperative classification of stage I endometrial carcinoma,these two methods all can provide valid evidence.Especially the enhance of assessing muscle infiltration depth and postoperative pathology consistency by TVS-CEUS,it is expected to become a non-invasive,safe and reliable method to evaluate preoperative classification in stage I endometrial carcinoma after MRI.