Objective To explore the diagnostic value of MRI in assessing pathological staging, myometrial invasion, and lymph node metastasis (LNM) in patients with endometrial carcinoma (EC).
Methods A retrospective analysis was conducted on the medical records and MRI imaging data of 80 female patients (age (57.5±6.7) years) who were diagnosed with EC by biopsy histopathological examination at Xi′an Third Hospital between June 2021 and December 2023. Endometrial biopsy histopathological examination results served as the "gold standard". Clinical characteristics were recorded, and the consistency between MRI and histopathological results in determining pathological staging, myometrial invasion, and LNM was assessed using the Kappa test.
Results According to biopsy histopathological examination, the distribution of EC stages among the 80 patients was as follows: stage Ⅰa (41.25%, 33/80), stage Ⅰb (26.25%, 21/80), stage Ⅱ (18.75%, 15/80), and stages Ⅲ–Ⅳ (13.75%, 11/80). MRI-based pathological staging results identified 31 cases as stage Ⅰa, 22 as stage Ⅰb, 16 as stage Ⅱ, and 11 as stages Ⅲ–Ⅳ. The sensitivity of MRI for diagnosing stages Ⅰa, Ⅰb, Ⅱ, and Ⅲ–Ⅳ was 87.88% (29/33), 90.48% (19/21), 86.67% (13/15), and 81.82% (9/11), respectively. The respective specificities were 95.74% (45/47), 94.92% (56/59), 95.38% (62/65), and 97.10% (67/69), with accuracies of 92.50% (74/80), 93.75% (75/80), 93.75% (75/80), and 95.00% (76/80). Corresponding Kappa values were 0.844, 0.841, 0.800, and 0.789 (all P<0.05). As for myometrial invasion, MRI identified 49 patients with myometrial invasion depth of ≥50% and 31 with invasion depth of <50%. For LNM, 9 patients were LNM positive, and 71 were negative. The sensitivity, specificity, accuracy, and Kappa value of MRI were respectively 95.74% (45/47), 87.88% (29/33), 92.50% (74/80), and 0.844 (P<0.05) in diagnosing myometrial invasion and 87.50% (7/8), 97.22% (70/72), 96.25% (77/80), and 0.803 (P<0.05) in diagnosing LNM in patients with EC.
Conclusions MRI demonstrates a good diagnostic efficacy for EC and has a good consistency with the endometrial biopsy histopathological examination, demonstrating its effectiveness for the rapid clinical diagnosis of EC.
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