巨大浆膜下子宫肌瘤的CT诊断及鉴别诊断  

CT Diagnosis and Differential Diagnosis of Huge Subserous Hysteromyoma

作　　者：宦坚[1] 张博[1] 张伟[1] 徐亮[1] 周洁瑕[1] 龚建平[1] 

机构地区：[1]苏州大学附属第二医院影像科,江苏苏州215004

出　　处：《实用放射学杂志》2010年第9期1308-1311,共4页Journal of Practical Radiology

摘　　要：目的 探讨巨大浆膜下子宫肌瘤（huge subserous hysteromyoma,HSH）的螺旋CT表现及诊断价值,旨在提高术前诊断水平.方法 回顾性分析经手术病理证实的12例患者HSH的螺旋CT特征,并与病理结果进行对照.结果 12例患者（共13个病灶）均在下腹部及盆腔内显示巨大肿块,突出于子宫轮廓外.13个病灶中,肿瘤最大直径范围为12～36 cm.CT表现为均匀实性肿块3个病灶,非均匀囊实性肿块10个病灶.增强扫描示肿块实性成分与子宫体强化程度基本一致,混杂密度区呈同心圆/漩涡状强化,囊性成分强化不明显.其中10个非均匀囊实性肿块中,玻璃样变性3例,黏液样变性4例,液化坏死囊性变2例,脂肪变性1例.结论 螺旋CT对巨大浆膜下子宫肌瘤的来源、其内不同性质的变性以及鉴别诊断具有较高的价值.Objective To discuss imaging features and the diagnostic value uf spiral CT for huge subserous hysteromyoma （HSH） ,so that to improve the ability of pre--operation diagnosis. Methods Clinical dala and CT findings of 12 patients with HSH proved by operation and pathology were retrospectively analyzed in comparison with pathology results . Results There were totally 13 masses in 12 patients. The maximal diameter of the hysteromyoma ranged from 12 cm to 36 cm. 3 tumors were homogeneous solid masses and 10 were inhomogeneous cystic-solid masses. The solid parts of tumors were homogeneous enhanced similar to nor real uterus tissue after contrast--enhanced scan, while the mixed density parts appeared as a concentric circle or vortex enhancement. Among the 10 lesions of inhomogeneous cystic solid, pathology showed hyaline degeneration in 3, mucoid degeneration in 4, necrosis and liquefaction in 2 and fatty degeneration in 1. Conclusion Spiral CT is useful techniques in demonstrating the origin and different degeneration of IISH as well as differentiating diagnosis.

关 键 词：子宫 子宫肌瘤 体层摄影术 X线计算机 

分 类 号：R737.33[医药卫生—肿瘤] R814.42[医药卫生—临床医学]