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  

The value of magnetic resonance diffusion weighted imaging in discriminating uterine sarcoma from other benign uterine lesions

作　　者：张国福[1] 谷守欣[1] 张鹤[1] 田晓梅[1] 

机构地区：[1]复旦大学附属妇产科医院放射科,上海200011

出　　处：《复旦学报（医学版）》2015年第3期373-378,共6页Fudan University Journal of Medical Sciences

基　　金：上海市卫生与计划生育委员会重点项目(20114011)~~

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。Objective To evaluate the value of diffusion weighted imaging（DWI） in categorizing sarcoma from uterine leiomyoma and compare with the pathological findings.Methods We respectively review 22 histopathologically proven primary uterine sarcomas from Jan,2010 to Dec.,2012 in our hospital.All cases prospectively underwent the MRI and DWI-MRI examinations.Taking leiomyoma and adenomyoma as the comparative group,apparent diffusion coefficient values （ADCs） were recorded and compared within tumour subtypes.Results The final histological diagnosis included 7 cases of leiomyosarcomas,3 endometrical stromal sarcomas,6 adenosarcomas and 6 carcinosarcomas.Most of uterine sarcomas （14 / 20,70 ％） appeared homogeneous high signal on DWI-MRI.The mean ADCs in uterine sarcomas [（1.05 ± 0.30）× 10-3 · mm-2 · s-1] was lower than leiomyoma [（1.34 ± 0.42） × 10-3 · mm-2 · s-1] and adenomyoma [（1.12 ± 0.14） × 10-3 · mm-2 · s-1].There was significant difference in ADCs between uterine sarcomas and uterine fibroids （P =0.019）.Some overlaps of ADCs within tumour subtypes were observed.There was significant difference in ADCs between leiomyosarcoma and leiomyoma （P =0.018）.Conclusions In addition to conventional uterine sarcomas.DWI-MRI characteristics have no specific signs within any subtyping of uterine sarcomas.ADCs could be helpful in discriminating uterine sarcoma from uterine fibroids.

关 键 词：子宫肉瘤 磁共振成像 弥散加权成像 

分 类 号：R737.33[医药卫生—肿瘤]