子宫静脉内平滑肌瘤病的MRI表现  

Intravenous Leiomyomatosis of the Uterus: MRI Findings with Histopathological Correlation

作　　者：周清[1] 马凤华[1] 刘佳[1] 王雪珍[1] 田晓梅[1] 张国福[1] 

机构地区：[1]复旦大学附属妇产科医院放射科

出　　处：《中国医学计算机成像杂志》2016年第3期243-248,共6页Chinese Computed Medical Imaging

基　　金：上海市卫生与计划生育委员会重点项目No.20114011~~

摘　　要：目的:探讨子宫静脉内平滑肌瘤病的MRI常规检查及DWI诊断价值。方法:回顾性分析经手术、病理证实的11例子宫静脉内平滑肌瘤病的临床及MRI资料,观察肿瘤的形态、部位、大小、信号及强化方式、DWI信号及ADC值等特征,并与手术病理对照。结果:11例子宫IVL均位于子宫肌层或宫旁,直径9.2±2.5 cm;肿瘤形态不规则、在子宫肌层迂曲、穿梭及边界欠清晰7例(64%),形态规则、边界清晰4例(36%);质地呈完全实性10例(91%);T2WI均匀等略高信号4例(36%),不均高信号7例(64%);11例肿瘤均呈较明显强化,早期明显强化、延迟期仍明显强化7例(64%)。病灶内或病灶旁可见迂曲血管8例(73%)。肿瘤DWI等信号4例(36%),稍高信号6例(55%),高信号1例(9%),ADC均值1.383×10^(-3) mm^2,与正常子宫肌层ADC值(1.442×10^(-3) mm^2)均值无显著性差异(P>0.05)。结论:子宫IVL典型MRI表现为子宫肌层或宫旁不规则迂曲、穿梭、实性肿块伴肿瘤内或瘤旁多发迂曲血管,DWI高或稍高信号,但ADC值无明显降低。Purpose： To investigate diagnostic value of conventional magnetic resonance imaging（MRI） and diffusion-weighted imaging（DWI） for the intravenous leiomyomatosis（IVL） in the uterus. Methods： We retrospectively studied the MR images of 11 pathologically proved IVL. The MRI features including tumor morphology,location,size,enhancement pattern,signal characteristics of DWI,and ADC value were correlated with the pathological findings. Results： Eleven cases of uterine IVL were located in the myometrium or next to the uterus,with the mean diameter of 9.2 ± 2.5 cm. MRI features of IVL were worm-like,irregular（7/11,64%）,solid mass in the myometrium（10/11,91%）; regular shape（4/11,36%）; homogeneous（4/11,36%） iso-signal intensity or heterogeneous（7/11,64%） high signal intensity on T2WI; obvious（11/11,100%） enhancement and persisted enhancement in the delayed period（7/11,64%）. Iso-signal intensity was seen in 4 cases（36%） and slightly high signal intensity was seen in 6 cases（55%） on DWI. The mean ADC values of IVL was 1.383×10^-3mm^-2,with no statistical significant difference when compared with that of normal myometrium（1.442×10^-3mm^-2）（P 〈0.05）. Conclusions： MRI can identify the characteristic features of IVL. IVL often appears as an irregular,worm-like solid mass,with multiple blood vessels within the tumor or surround the tumor in myometrium. The signal intensity of IVL is often high or slightly high on DWI,and the ADC value is not decreased.

关 键 词：子宫 静脉内平滑肌瘤病 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]