磁共振弥散加权成像鉴别子宫肉瘤和其他子宫良性肿块的价值

发布时间：2018-08-11 09:01

【摘要】：目的探讨磁共振弥散加权成像(DWI-MRI)对子宫肉瘤的诊断价值,并同组织病理学进行对照。方法回顾性分析复旦大学附属妇产科医院2010年1月至2012年12月间,22例经组织病理学证实的子宫肉瘤病例。所有病例均前瞻性行MRI和DWI-MRI检查。将子宫肌瘤和子宫腺肌症作为对照组,比较不同组别间表观弥散系数值(apparent diffusion coefficient values,ADCs)的差异性。结果本组资料包括7例平滑肌肉瘤,3例子宫内膜间质肉瘤,6例腺肉瘤和6例癌肉瘤。大多数子宫肉瘤(14/20,70%)在DWI-MRI上表现为均质高信号。子宫肉瘤平均ADC值为[(1.05±0.30)×10-3·mm-2·s-1],低于子宫肌瘤[(1.34±0.42)×10-3·mm-2·s-1]和腺肌瘤[(1.12±0.14)×10-3·mm-2·s-1],其中子宫肉瘤和平滑肌瘤间ADC值差别具有显著统计学意义(P=0.019)。在不同亚型子宫肉瘤中,ADC值存在重叠,平滑肌肉瘤和平滑肌瘤间存在显著统计学意义(P=0.018)。结论DWI-MRI可在常规MRI基础上对子宫肉瘤的诊断提供必要的附加信息,通过ADC值定量分析有助于鉴别子宫肉瘤和子宫肌瘤,但子宫肉瘤不同亚型间ADC值不具显著性差异。
[Abstract]:Objective to evaluate the diagnostic value of diffusion-weighted magnetic resonance imaging (DWI-MRI) in uterine sarcoma and to compare it with histopathology. Methods 22 cases of uterine sarcoma confirmed by histopathology were analyzed retrospectively from January 2010 to December 2012 in the affiliated Obstetrics and Gynecology Hospital of Fudan University. MRI and DWI-MRI were performed prospectively in all cases. Uterine leiomyoma and uterine adenomyosis were used as control group to compare the difference of apparent diffusion coefficient (apparent diffusion coefficient value ADCs) between different groups. Results the data included 7 cases of leiomyosarcoma, 3 cases of endometrial stromal sarcoma, 6 cases of adenosarcoma and 6 cases of carcinosarcoma. Most uterine sarcomas (14 / 2070%) showed homogeneous hyperintensity on DWI-MRI. The average ADC value of uterine sarcoma [(1.05 卤0.30) 脳 10-3 mm-2 s-1] was lower than that of uterine leiomyoma [(1.34 卤0.42) 脳 10-3 mm-2 s-1] and adenomyoma [(1.12 卤0.14) 脳 10-3 mm-2 s-1]. There was significant difference in ADC between uterine sarcoma and leiomyoma (P0.019). The ADC values of leiomyosarcoma and leiomyoma were overlapped in different subtypes of uterine sarcoma (P0. 018), and significant difference was found between leiomyosarcoma and leiomyoma (P0. 018). Conclusion DWI-MRI can provide necessary additional information for the diagnosis of uterine sarcoma on the basis of routine MRI. Quantitative analysis of ADC value is helpful to differentiate uterine sarcoma from uterine leiomyoma, but there is no significant difference in ADC value among different subtypes of uterine sarcoma.
【作者单位】：复旦大学附属妇产科医院放射科;
【基金】：上海市卫生与计划生育委员会重点项目(20114011)~~
【分类号】：R737.33;R445.2

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