妊娠滋养细胞肿瘤化疗前后MRI表现与分析  

MRI features of gestational trophoblastic neoplasia in pre-and post-chemotherapy

作　　者：赵维敬[1] 梁宇霆[1] 王新莲[1] 王克扬[1] 李彪[1] ZHAO Weijing;LIANG Yuting;WANG Xinlian;WANG Keyang;LI Biao(Department of Radiology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院放射科,北京100006

出　　处：《实用放射学杂志》2021年第6期958-960,964,共4页Journal of Practical Radiology

基　　金：首都医科大学附属北京妇产医院中青年学科骨干培养专项项目(fcyy201617)。

摘　　要：目的对比分析妊娠滋养细胞肿瘤(GTN)化疗前后的MRI表现.方法回顾性分析9例临床和病理明确诊断GTN患者的临床和MRI资料.结果化疗前9例病灶呈团块状,侵犯子宫肌层,病灶信号不均匀.肌层多发流空血管影.动态增强早期病灶及邻近肌层呈血管样强化;病灶实性部分逐渐强化;延时期病灶实性部分明显强化,与肌层分界不清.扩散加权成像(DWI)呈等、低信号,局部出血呈高信号.化疗后9例病灶明显缩小(t=7.965,P=0.000),病灶之间信号相对一致.病灶与肌层之间存在明显分界线,呈T_(1)WI稍高信号,T_(2)WI极低信号.肌层流空血管影消失.动态增强早期病灶及邻近肌层血管样强化消失;延时期病灶无强化,病灶与肌层间分界面清晰、光滑.DWI呈等、高、低不同信号.结论GTN化疗前后病灶与肌层的关系和强化过程具有不同的MRI特征,对比分析提高了影像表现的认识.Objective To analyze the MRI manifestations of gestational trophoblastic neoplasia(GTN)in pre-and post-chemotherapy.Methods The clinical and MRI data of 9 cases with GTN confirmed by pathology and clinical diagnosis were analyzed retrospectively.Results In pre-chemotherapy,the lesions presented as the masses with inhomogeneous signal and invaded the myometrium in all 9 cases.The flow voids of vessels in the myometrium were displayed clearly on T_(2)WI.During the early phases of dynamic contrast enhancement,the lesions and the myometrium looked like vascular enhancement.The solid component of lesions was gradually enhanced,in the delayed phase,the solid component was significantly enhanced,and the boundary between lesion and myometrium was unclear.The lesions were isoor hypo-signal on diffusion weighted imaging(DWI)in all cases except for some hemorrhagic areas,which were hyper-signal.In post-chemotherapy,the lesions became smaller obviously(t=7.965,P=0.000)and had relatively uniform signal in all 9 cases.The clear boundary between lesion and myometrium showed slight hyper-signal on T_(1)WI and extreme hypo-signal on T_(2)WI.The manifestations were disappeared,including the flow voids of vessels in the myometrium and vascular enhancement in the lesions and the myometrium.In the delayed phase,the lesions had no enhancement and the boundary between lesion and myometrium was clear and smooth.The lesions showed various signal including iso-signal,hyper-signal and hypo-signal on DWI.Conclusion MEU manifestations of GTN in pre-and post-chemotherapy have different characteristics in the relationship between lesion and myometrium and the enhanced process.The control study improves the recognition of imaging manifestations.

关 键 词：妊娠滋养细胞肿瘤 侵蚀性葡萄胎 绒毛膜癌 磁共振成像 

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