子宫内膜间质肉瘤的MRI表现  

MRI findings of endometrial stromal sarcomas

作　　者：蔡妙田 张修石[1] 郑建[1] 周洋[1] 张红霞[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院影像中心,黑龙江哈尔滨150081

出　　处：《现代肿瘤医学》2015年第12期1731-1734,共4页Journal of Modern Oncology

摘　　要：目的:探讨子宫内膜间质肉瘤的MRI表现特点。方法:回顾性分析7例经手术及病理证实的子宫内膜间质肉瘤患者的临床和MRI资料。所有病例均行MRI平扫。结果:本组7例患者子宫体积均增大。6例病变位于宫腔内,呈息肉状突向宫腔或弥漫性填充宫腔;1例位于子宫肌壁间,类似囊性变性子宫肌瘤。2例囊实混合性占位,5例实性占位。7例ESS病变直径范围为2.5cm-15cm,平均8.8cm。肿瘤在MRI平扫上5例T1WI呈等信号或低信号,T2WI呈稍高信号;2例T1WI呈等及低信号,T2WI呈稍高为主的混杂信号,伴有出血或坏死囊变,其中1例位于子宫肌壁间。6例可见向子宫肌层侵润性生长,子宫T2WI结合带低信号中断或消失,其中1例可见宫颈、双侧输卵管壁、卵巢及膀胱受侵,1例子宫肌层及宫旁可见扭曲条点状流空信号影。4例合并少量盆腔积液,2例合并子宫肌瘤,1例合并卵巢滤泡囊肿,3例合并增殖期子宫内膜。病理示低度恶性ESS 6例,未分化ESS 1例。结论:子宫内膜间质肉瘤好发于宫腔内,也可见于子宫肌壁间,多向子宫肌层浸润性生长,于T1WI呈等或低信号,T2WI呈稍高信号,伴出血或坏死囊变时呈T2WI稍高信号为主的混杂信号,其在MRI上具有一定的信号特点,能为该病的诊断提供帮助。Objective：To study the MRI manifestation of endometrial stromal sarcoma（ESS）. Methods：To retro- spectively analyze clinical and MRI data of 7 patients with surgery and pathology confirmed. All cases were performed conventional MRI imaging. Results：All 7 cases had enlargement uterus. Uterine cavity mass were found in 6 cases, which show protruding into the uterine cavity like polypoid or filling uterine cavity diffusely. Myometrial mass were found in 1 case,which was similar to cystic degeneration of uterine fibroids. Lesions in 2 cases were cystic and solid component,5 cases were solid component. The mean diameter of lesions was 8.8 centimeter, a range of 2.5cm to 15cm. 5 cases showed low or iso - signal intensity on T1WI and slightly high signal intensity on T2WI. 2 cases showed low and iso - signal intensity on T1WI and slightly high singal - based mixed signal intensity on T2WI due to hemor- rhage and cystic degeneration within masses, one of which was located in myometrium. 6 lesions invaded myometrium and lead to the disconnection or disappearance of the connection band of uterus with low signal intensity on T2WI. 1 case involved the cervix, fallopian, ovary and bladder. 1 case showed distorted point - like flow void signal in the myo- metrium and parametrium. There were 4 cases accompanied with pelvic effusion,2 cases with uterine leiomyoma, 1 case with follicular cysts ,3 cases with proliferative endometrium merger. Pathological diagnosis displayed low -grade endometrial stromal sarcoma in 6 patients, undifferentiated endometrial stromal sarcoma 1 patient. Conclusion ： Most of endometrial stromal sarcoma are located in uterine cavity, also in myometrium, showing invasive growth into myometri- um. The manifestation of endometrial stromal sarcoma on MRI imaging has a certain characteristics, which is low or iso - signal intensity on T1WI and slightly high signal intensity on T2WI and slightly high singal - based mixed signal in- tensity on T2WI due to hemorrhage and cystic degeneration within mas

关 键 词：子宫内膜间质肉瘤 磁共振成像 病理学 诊断 

分 类 号：R737.33[医药卫生—肿瘤]