良恶性滋养细胞疾病的影像诊断与鉴别诊断  

MRI Diagnosis and Differential Diagnosis of Benign and Malignant Gestational Trophoblastic Disease

作　　者：毛咪咪 周存凉[1] 冯峰[1] 傅爱燕[1] 石健[1] MAO Mimi;ZHOU Cunliang;FENG Feng;FU Aiyan;SHI Jian(Department of Radiology,Nantong Tumor Hospital Affiliated to Nantong University,Nantong 226361,China)

机构地区：[1]南通市肿瘤医院影像科,江苏南通226361

出　　处：《CT理论与应用研究（中英文）》2021年第4期511-518,共8页Computerized Tomography Theory and Applications

基　　金：南通市卫生健康委员会科研立项课题(QA2019031)。

摘　　要：目的:探讨MRI对良恶性滋养细胞疾病(GTD)的诊断价值。方法:回顾性分析55例(良性15例,恶性40例)经临床手术病理证实GTD的MRI表现。结果:15例良性病灶均位于宫腔,子宫肌层无受累;40例恶性病灶位于宫腔26例,宫颈管2例,均伴有子宫肌层浸润;位于子宫肌层12例,位于肌层的病灶,子宫结合带连续。MRI表现为病灶呈混杂信号影,T1WI于低信号中夹杂高信号者良性3例、恶性20例;增强扫描后40例恶性病变中10例呈动脉期强化,15例病灶分隔及实性部分中度以上强化,15例囊性病灶中央可见"暴风雪"样强化。良性均呈分隔状、渐进性持续性强化。31例恶性病变周围及肌层、宫旁可见增多增粗迂曲的流空血管影,5例良性病变宫旁见增多血管影,MR增强扫描显示清晰。结论:良恶性GTD的MRI表现具有一定特征性,可以很好的显示肿瘤侵及范围,早期有助于提示良恶性,为临床诊断及治疗提供依据。Objective: To explore the diagnostic value of MRI for benign and malignant gestational trophoblastic disease. Methods: retrospective analysis of 55 cases(15 benign, 40 malignant) confirmed the MRI manifestations of GTD by clinical operation and pathology.Results:15 cases of benign lesions were all located in the uterine cavity, and the myometrium was not affected;40 cases of malignant lesions were located in the uterine cavity in 26 cases, and in 2 cases of the cervical canal, all with myometrial infiltration;12 cases were located in the myometrium, and the uterine junction zone was continuous. MRI showed that the lesion showed mixed signal shadow, 3 cases of benign and 20 malignant cases were mixed with high signal on T1 WI;After the enhanced scan, 10 of the 40 malignant lesions showed arterial enhancement, 15 cases of lesion separation and solid part were moderately enhanced, 15 cases of cystic lesions showed "blizzard"-like enhancement in the center. The benign ones are separated and gradually strengthened continuously. In 31 cases of malignant lesions, there were more thick and tortuous vascular shadows around the muscle layer and uterus. 5 cases of benign lesions with increased vascular shadows around the palace. Conclusion: The MRI manifestations of benign and malignant GTD have certain characteristics, which can well show the extent of tumor invasion, and help prompt benign and malignant early, and provide basis for clinical diagnosis and treatment.

关 键 词：滋养细胞疾病 磁共振成像 鉴别诊断 

分 类 号：R445[医药卫生—影像医学与核医学]