子宫平滑肌瘤变性的CT诊断及鉴别诊断  

Diagnosis and differential diagnosis of degeneration of myoma uterus on CT

作　　者：张海金[1] 王志峰[1] 

机构地区：[1]嘉兴市妇幼保健院放射科,浙江嘉兴314000

出　　处：《实用放射学杂志》2016年第1期72-74,共3页Journal of Practical Radiology

摘　　要：目的 探讨CT在子宫肌瘤变性的诊断价值及子宫肌瘤变性的CT特征。方法 回顾性分析手术病理证实的23例子宫肌瘤变性的临床资料和CT资料，并将CT表现与手术病理进行对照。结果 变性肿瘤25个，横断面最大直径 30 cm，最小直径 1.5 cm，平均 4.5 cm。宫体肿瘤18个（72%），宫颈肿瘤5个（20%），阔韧带肿瘤2个（8%）；肌壁间型肿瘤13个（52%），浆膜下型肿瘤10个（40%），黏膜下型肿瘤2个（8%）。24个变性肿瘤CT平扫呈混杂密度，增强扫描呈不均匀强化，经病理证实肿瘤内玻璃样变13个（52%），囊性变伴玻璃样变4个（16%），红色变性3个（10%），脂肪变性伴玻璃样变2个（8%），钙化伴玻璃样变2个（8%）。1个变性肿瘤CT平扫呈均匀偏低密度，增强扫描仅见囊壁强化，病理证实肿瘤内黏液性变（4%）。结论 CT平扫加增强扫描对于子宫肌瘤不同性质变性的诊断以及鉴别诊断具有重要的价值。Objective To evaluate the value of CT in detection of the degeneration of myoma uterus and to probe its imaging char acteristics. Methods The clinical data and CT findings in 23 patients with degeneration of myoma uterus proven by pathology were analyzed retrospectively. The CT findings of degenerative myoma uterus were compared with the pathological results. Results 25 myomas with degeneration were found in the study with a mean diameter of 4. 5 cm ranged from 30 cm to 1. 5 crn. Among the tumors, 18 were located at the body of uterus （72%） , 5 at the neck of uterus （20%）, 2 at the broad ligament of uterus （8%）,13 at myometrium （ 52%） , 10 at submucousa （ 40%） and 2 at subserousa （ 8% ）. The 24 myomas demonstrated inhomogeneous density on plain and enhanced CT with hyaline degeneration in 13（52%）, liquification in combination with hyaline degeneration in 4（16%）, red degeneration in 3（10 %）, fatty degeneration in combination with hyaline one in 2（8 %） and calcification in combination with hya line degeneration in 2. Only one tumor demonstrated cystic density on plain CT and hyperdensity of cystic wall on enhanced CT who was proved as mucoid degeneration by pathology. Conclusion Pre and post-contrast enhanced CT is helpful for the diagnosis and dif ferential diagnosis of different degenerations of myoma uterus.

关 键 词：子宫肌瘤 变性 计算机体层成像 

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