子宫内膜息肉和Ⅰ期子宫内膜癌的MRI特征分析  

MRI featuresofendometrial polyps and stage-Ⅰ endometrial cancer

作　　者：王雪[1] 黄雅南[1] 朱欢乐[1] 白光辉[1] 周璐[1] 周盼盼[1] 叶信健[1] 陈裕[1] 严志汉[1] 

机构地区：[1]浙江省温州医科大学附属第二医院放射科,325005

出　　处：《中华全科医学》2015年第11期1824-1827,F0003,共5页Chinese Journal of General Practice

基　　金：浙江省温州市科技局医疗卫生项目(Y20140399);浙江省温州市科技局对外合作项目(H20090073)

摘　　要：目的分析子宫内膜息肉及Ⅰ期子宫内膜癌的MR平扫、DWI及增强扫描特征。方法回顾性分析经手术病理证实的子宫内膜息肉13例,Ⅰ期子宫内膜癌19例,对其MR平扫、DWI及增强扫描特征和ADC伪彩图、ADC值进行对比分析。结果 13例子宫内膜息肉在T2WI表现为稍低信号或等信号,在DWI呈低或稍高信号,ADC伪彩图以绿色为主,增强扫描呈持续渐进性强化。19例Ⅰ期子宫内膜癌在T2WI表现为等或稍高信号,在DWI呈高信号,ADC伪彩图以蓝色为主,强化方式为快进慢出型。13例内膜息肉ADC值[(1.45±0.25)×10-3mm2/s]高于19例Ⅰ期子宫内膜癌的ADC值[(0.74±0.09)×10-3mm2/s],差异有统计学意义(P<0.01)。肿块内纤维核、囊变、出血、窄基底、肿块带蒂及完整结合带在子宫内膜息肉(9/13、10/13、7/13、8/13、3/13、13/13)中出现的概率均高于子宫内膜癌(3/19、3/19、0/19、2/19、0/19、2/19),差异有统计学意义(P<0.01)。结论 MRI对子宫内膜息肉及Ⅰ期子宫内膜癌的诊断和鉴别诊断有较大价值。Objective To study the futures ofendometrial polyps and stage- I endometrialcancer byunenhanced MRI, diffusion-weighted MRI（DW-MRI） and dynamic contrast-enhanced MRI（DCE-MRI）. Methods Total 13 cases ofendometrial polyps and 19 cases of stage- I endometrial cancer confirmed by histopathological examination were enrolled into this study. MRI findings including unenhanced MRI, DW-MRI, pseudo-color apparent diffusion coefficient （ADC） maps and ADC value were compared. Results Ten cases of endometrial polys exhibited as slightly lowsignal intensity or iso-signal intensityon T2 weighted image（T2WI） ,lightly low signal intensity to high signalintensity on DWI ,the main color of ADC map was mainlygreen, and gradually increasing enhancement;19 cases of stage- I endometrial cancer appeared as iso-sig- nal intensityto slightly high signalintensity on T2WI, high signalintensity on DWI and＂fast in slow out＂ enhancement. The main color of ADC map was blue. The ADC value of polyps [ （ 1.45 ±0.25）×10-3 mm2/s ] were higherthan [ （0.74 ±0.09）×10-3 mm2/s] of endometrial cancer（ P 〈 0.01 ）. An irregular central fibrous core, small non-enhanced intratumoral cysts, hemorrhage, narrow base, pedicle flapand intact junction zonewere seen more frequently in endometrial polyps （9/13,10/13,7/13,8/13,3/13,13/13） than in stage- I endometrial cancer（ 3/19,3/19,0/19,2/19,0/19,2/19 ）, P 〈 0.01. Conclusion MRI can be helpful in the diagnosis and differential diagnosis ofendometrial polyps andstage- I endometrial cancer.

关 键 词：子宫内膜病变 磁共振成像 鉴别诊断 

分 类 号：R737.33[医药卫生—肿瘤]