자궁암의 병기결정에서 자기공명영상술과 병리학적 결과와의 비교연구

초록

purpose: To evaluate the usefulness of preoperative MR imaging in assessing the TNM staging of endome-trial carcinoma in comparison with histopathology/ Materials and Methods:MR imaging findings of 18conseucutive patients with histologically proven endometrial carcinoma, were retrospectvely analyzed and compared with pathologic results. All patients underwent conventional MR imaging(axial T1W1. axial, sagittal, and coronal T2W1)with contrast enhanced Mrimaging. Dynamic enhanced EFGRE T1W1 was done in 6 patients. Tumoral morphology (polypoid/diffuse). depth of myometrial invasion (stage IA, IB, and IC), dis-ruption of junctional zone were evaluated. We also compared the time-signal intensity curve of tumor with normal myometrium on contrast enhanced dynamic EFGRE MR imaging. Results:The staging accuracy of MR imaging were 88.9%(16/18) in stage IA; 72.2%(13/18) in stage IB;83.3%(15/18) in stage IC, respectively. The overall accuracy was 81.5%. Six of 7 incorrect cases were underestimated, and one was overstimated. Disruption of junctional zone influenced myometrial invasion assessment. Nine of 12 patients(75%)with polypoid tumor on MR imaging were histopathologic tumor grade 1 and the others were grade 2. Five of 6patients(83%) with diffuse tumor were grade 2 or 3 and one was grade 1.Tumor was enhanced in early arterialphase but less enhanced than normal myometrium on contrast enhanced dynamic EFGRE MR imagings. Conclusion:MR imaging must be useful for the identi-fying the stage of endometrial carcinoma. In addition, the tumoral morphology (polypoid/diffuse) well corre-lates with histopathologic tumor grade, but there is no significant differences between the tumor and normal myometrial enhancement.