子宫肌瘤的MRI诊断  

Diagnosis of uterine leiomyoma by MRI

作　　者：郑蔚巍[1] 王述静[1] 周康荣[1] 陈祖望[1] 沈继章[1] 陈财忠[1] 

机构地区：[1]上海医科大学附属中山医院放射科,200032

出　　处：《中华放射学杂志》2001年第5期383-385,共3页Chinese Journal of Radiology

摘　　要：目的　探讨MRI对子宫肌瘤的诊断价值及其表现特征。方法　对 2 6例疑子宫肌瘤的患者分别行B超和盆腔MRT1WI、T2 WI多方位扫描 ,其中 11例同时行动态增强检查 ,并与术后病理进行对照分析。结果　除 2例术后病理证实为内膜息肉和卵巢炎性假瘤外 ,余MRI诊断均与术后病理相符 ,诊断准确率为 92 %。B超确诊 2 2例 ,准确率 85 %。以手术病理为标准 ,MRI病灶检出率为 89%(5 5 /6 2 ) ,B超检出率为 6 9% (43/6 2 ) ,统计学比较有显著性差异 (χ2 =17.86 ,P <0 .0 5 )。子宫均有不同程度增大或轮廓改变 ,宫腔变形。肌瘤在T1WI上表现为等或低信号 ,T2 WI上表现为低或混杂信号 ,动态增强后强化不均匀。结论　MRI在显示肌瘤的大小、位置及与宫腔的关系上有较高的诊断价值 ,可作为B超检查的重要补充手段。Objective To investigate the MR features of uterine leiomyomas and evaluate its diagnostic value. Methods Twenty six patients with probable uterine leiomyomas underwent preoperative ultrasound, T 1 weighted spin echo and T 2 weighted fast spin echo MR examinations. Among them, 11 cases were performed with dynamic contrast enhancement. Comparative analysis between MRI findings and pathologic results was done. Results MRI diagnosis in all cases was consistent with the results given by surgery and pathology, except 2 being pathologically proven as endometrial polyp or inflammatory pseudoplasma. The diagnostic accuracy of MRI was 92%, while the accuracy of ultrasound was 85%. The difference between the number of lesions detected by two modalities had statistical significance (89% for MRI vs 69% for ultrasound, χ 2=17.86, P <0.05). All cases showed enlargement of uterus or irregular uterine contour, and endometrial lumen distortion in certain degree. The lesions presented as intermediate or low signal intensity on T 1WI, low or heterogeneous signal intensity on T 2WI. On dynamic and delayed contrast enhanced images, the majority of leiomyomas enhanced heterogeneously to a lesser degree than the normal myometrium and remained well marginated. Conclusion MRI has high value in diagnosing leiomyomas with respect to the size, position and relationship with uterine cavity. It could be used as an important complementary method to ultrasound.

关 键 词：子宫肿瘤 磁共振成像 子宫肌瘤 B超 诊断 

分 类 号：R737.33[医药卫生—肿瘤] R730.44[医药卫生—临床医学]