MRI在子宫肌瘤与子宫腺肌病鉴别诊断中的临床价值  

Clinical value of MRI in differential diagnosis between hysteromyoma and adenomyosis

作　　者：朱志梅[1] 彭康明[1] 程敏[1] 郭俭[2] 任春霞[2] ZHU Zhimei;PENG Kangming;CHENG Min(Department of Radiology,People’s Hospital of Rugao City,Jiangsu,Rugao 226500,China)

机构地区：[1]江苏省如皋市人民医院放射科,226500 [2]江苏省无锡市人民医院妇科

出　　处：《河北医药》2019年第21期3284-3287,共4页Hebei Medical Journal

基　　金：国家自然科学基金青年科学基金项目(编号:81402153)

摘　　要：目的探讨MRI在子宫肌瘤与子宫腺肌病鉴别诊断中的临床价值。方法回顾性收集诊断为子宫肌瘤患者45例(子宫肌瘤组),子宫腺肌病患者38例(子宫腺肌病组),2组患者均进行MRI检查,均经手术或病理组织学检查确诊,对2组患者临床病理分型、MRI表现进行分析,并分析MRI对子宫肌瘤和子宫腺肌病的诊断价值。结果子宫肌瘤患者在T1WI上均为等信号或低信号,在T2WI中普通型的信号远低于子宫肌层且均匀,退变型为低信号内夹杂有斑片状高信号,细胞型呈均匀高信号,子宫腺肌病在T1WI中可为低信号,也可高信号,T2WI中表现为低信号内夹杂有点状高信号病灶,增强扫描后病灶的强化不明显。MRI对子宫肌瘤诊断的符合率为91.1%,误诊率为8.9%,对子宫腺肌病诊断的符合率为89.5%,误诊率为10.5%。诊断符合率和误诊率比较,差异无统计学意义(P>0.05)。结论 MRI对子宫肌瘤和子宫腺肌病诊断时,图像特异性明显,且对两种疾病诊断的符合率高,操作简单,具有较高的临床应用价值,值得临床推广使用。Objective To investigate the clinical value of magnetic resonance imaging(MRI) in differential diagnosis between hysteromyoma and adenomyosis.Methods A total of 45 patients with hysteromyoma who were diagnosed and treated in our hospital were enrolled as hysteromyoma group,and the other 38 patients with adenomyosis were enrolled as adenomyosis group. The patients in both groups were examined by MRI and pathological examination.The clinicopathological types and MRI findings were observed and compared between the two groups.Moreover the application value of MRI in differential diagnosis between hysteromyoma and adenomyosis was evaluated.Results The patients with hysteromyoma showed equal or low signal in T1 WI,and the common type signal in T2 WI was much lower than that in uterine myometrium,and the degeneration type was low signal with patchy high signal,moreover, the cell type showed homogeneous high signal intensity.The adenomyosis was low or high signal in T1 WI,and the lesions presented as low signal with high signal intensity in T2 WI,the enhancement of lesions was not obvious after contrast-enhanced scanning.The coincidence rate of MRI in diagnosis of hysteromyoma was 91.1%,and the misdiagnosis rate was 8.9%,and the diagnostic accuracy of adenomyosis was 89.5%,and misdiagnosis rate was 10.5%,there were no significant differences in diagnosis coincidence rate and misdiagnosis rate by MRI in differential diagnosis between hysteromyoma and adenomyosis(P>0.05).Conclusion In the diagnosis of hysteromyoma and adenomyosis by MRI,the image specificity is obvious,which has higher diagnosis coincidence rate,with simple operation and higher clinical application value,therefor, which is worthy of clinical promotion.

关 键 词：子宫肌瘤 子宫腺肌病 磁共振成像 

分 类 号：R711.74[医药卫生—妇产科学]