目的 探讨子宫内膜癌应用CT平 扫与三期增强扫描的诊断价值。方法 选 取我院2015年1月-2016年12月收治的子宫 内膜癌患者53例，收集53例患者临床资 料、影像学资料等，由两名资深影像学医 师对53例患者CT平扫及CT三期增强扫描的 图像进行分析，比较两种方式对子宫内膜 癌的检出率及诊断准确率。结果 CT平扫 对子宫内膜癌的检出率及诊断准确率分别 为75.47%、67.92%，CT三期增强扫描对 子宫内膜癌的检出率及诊断准确率分别 为98.11%、94.33%，CT三期增强扫描对 子宫内膜癌的检出率及诊断准确率明显 优于CT平扫，数据差异具有统计学意义 (P<0.001)；在CT平扫中，36例(67.92%) 患者经图像测量，子宫均表现出不同程度 的增大，平均前后径(67.96±6.69)mm， 同时伴不同程度的子宫壁增厚，多数患 者子宫边缘界限模糊，子宫外观形态不 规则，14例(26.41%)患者宫旁间隙可见 条索状影。CT三期增强中，可见多数患 者宫腔内改变，宫腔出现不同程度的扩 大，在强化过程中，宫腔内部强化程度 明显低于子宫肌壁的乳头状、不规则状软 组织影，动脉期增厚子宫壁呈轻度强化， 内膜强化较为明显，至静脉期时，持续强 化，延迟期扫描时子宫内示持续强化；12 例(22.64%)出现子宫外播散等图像表现， 6例(11.32%)患者可见肠道受侵，12例 (22.64%)患者图像提示盆腔或腹膜后淋巴 结肿大。结论 CT增强扫描能直观显示子 宫内膜癌在不同时期的强化图像特点，可 提高其检出率及准确诊断率，有利于为临 床制定治疗方案提高可靠影像学资料。

Objective To investigate the diagnostic value of CT scan and three phase enhanced scan in endometrial carcinoma. Methods Select 53 patients with endometrial carcinoma treated in our hospital from January 2015 to December 2016, in 53 cases collect clinical data, imaging data and so on, the images of 53 patients with CT scan and CT three phase enhanced scan were analyzed by two senior imaging physicians, compare the detection rate and accuracy of endometrial carcinoma between the two methods. Results The detection rate and accuracy of CT scan for endometrial carcinoma were 75.47% and 67.92% respectively, the detection rate and accuracy of CT three phase scan for endometrial carcinoma were 98.11% and 94.33% respectively, the detection rate and accuracy of CT three phase scan in endometrial carcinoma were better than CT scan, the difference was statistically significant (P<0.001). In CT scan, in 36 patients (67.92%), the uterus showed different degrees of enlargement, with an average anteroposterior diameter (67.96±6.69)mm, at the same time, with different degrees of thickening of the uterine wall, the majority of the patients had blurred boundaries of the uterus and irregular appearance of the uterus. In 14 cases (26.41%), the cords were seen in the uterine space. In the three phase of CT enhancement, the majority of patients showed intrauterine changes, and the uterine cavity showed different degrees of enlargement, in the reinforcement process, the degree of strengthening in the uterine cavity was significantly lower than that of the papillary and irregular soft tissue in the uterine muscle wall. The arterial phase was thickened and the uterus wall was mildly strengthened, intimal enhancement was more pronounced and continued to strengthen during the venous phase, with persistent enhancement in the uterus during the delayed phase scan; In 12 cases (22.64%), the appearance of extra uterine dissemination was seen. In 6 cases (11.32%) the intestinal tract was invaded, and in 12 cases (22.64%) the images showed pelvic or retroperitoneal lymph nodes enlargement. Conclusion CT enhanced scan can display the enhanced image features of endometrial carcinoma at different stages, can improve the detection rate and accurate diagnosis rate, and is favorable for establishing a treatment plan for the clinic and improving reliable imaging data.