子宫腺瘤样瘤与子宫肌瘤MRI表现比较

发布时间：2018-06-26 08:12

本文选题：腺瘤样瘤 + 子宫肌瘤　；参考：《临床放射学杂志》2015年10期

【摘要】：目的比较子宫腺瘤样瘤(AT)和子宫肌瘤的MRI征象的异同,以提高对两者的鉴别诊断水平。方法回顾性分析经手术病理证实的28例(共30个病灶)子宫AT和78例(共166个病灶)子宫肌瘤患者的好发年龄和MRI表现,对比分析两者的T2WI、高信号分隔征、假包膜情况、T1WI增强的均匀度和强化比值的差异,并采用统计学方法检验。结果子宫AT和子宫肌瘤好发年龄均为中年妇女,部位以肌壁多见,平均直径约3.7~3.9 cm。子宫AT呈囊性病变伴实性结节或实性肿块,实性肿块T1WI呈等信号,19例(67.9%)T2WI呈均匀低信号,18例(64.3%)均匀强化,21例(75%)强化程度低于宫肌,仅2例(7.1%)出现假包膜。子宫肌瘤呈实性肿块,T1WI呈等信号,T2WI呈均匀或不均匀低信号;72个(43.4%)病灶内见斑片高信号、高信号分隔征,呈均匀或不均匀强化且强化程度多(81.9%,136/166)等于或高于宫肌,85个(51.2%)病灶可见假包膜。结论子宫AT的MRI表现与子宫肌瘤相似,T2WI高信号分隔征、强化程度等高于宫肌及出现假包膜或许是子宫肌瘤区分AT的特征表现,单发囊实性结节或实性结节T2WI呈均匀低信号、均匀强化且强化程度低于宫肌时需考虑到AT可能,最后确诊依靠病理检查。
[Abstract]:Objective to compare MRI findings of uterine adenomatoid tumor (AT) and uterine leiomyoma (hysteromyoma) in order to improve their differential diagnosis. Methods the age and MRI findings of 28 patients with uterine AT (30 lesions) and 78 patients with uterine leiomyoma (166 lesions) confirmed by surgery and pathology were retrospectively analyzed. The difference of enhancement uniformity and enhancement ratio on T _ 1WI in pseudocapsule was examined by statistical method. Results both the age of uterine AT and uterine leiomyoma were middle aged women. The most common site was muscle wall with an average diameter of 3.73.9 cm. Uterine AT presented cystic lesions with solid nodules or solid masses. 19 cases (67.9%) of solid masses showed iso-signal intensity on T _ 1WI, 18 cases (64.3%) showed homogeneous hypointensity on T _ 2WI, 21 cases (75%) showed homogeneous enhancement of uterine muscle, and only 2 cases (7.1%) showed false envelope. Uterine leiomyoma showed homogeneous or heterogeneous low signal intensity on T _ 1WI and hyperintensity in 72 lesions (43.4%). Homogeneous or uneven enhancement and multiple enhancement (81.9% 136 / 166) was equal to or higher than that of uterine muscle. Pseudocapsule was found in 85 lesions (51.2%). Conclusion the MRI findings of uterine AT are similar to hysteromyoma with high signal intensity on T _ 2WI, and the enhancement degree is higher than that of uterine muscle and pseudocapsule may be the characteristic feature of distinguishing AT from uterine myoma, and the single cystic solid or solid nodules show homogeneous low signal intensity on T _ 2WI. When homogeneous enhancement and enhancement degree is lower than that of uterine muscle, AT may be taken into account, and the final diagnosis depends on pathological examination.
【作者单位】：广州医科大学附属第一医院放射科;
【分类号】：R737.33;R445.2

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