女性原发性生殖系统癌肉瘤的临床影像分析  

Clinical imaging analysis of female primary reproductive system carcinosarcoma

作　　者：黄文鹏 李莉明[1] 朱丽娜 韩懿静 高剑波[1] HUANG Wenpeng;LI Liming;ZHU Lina;HAN Yijing;GAO Jianbo(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《实用放射学杂志》2021年第12期2006-2010,2021,共6页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81971615)。

摘　　要：目的探讨女性生殖系统癌肉瘤(CS)的CT和MRI表现特点。方法回顾性收集经病理确诊的女性生殖系统CS患者的临床及影像资料,共纳入57例患者,观察并评估病灶的位置、数目、形态、大小、边缘、包膜、密度或信号等,分析病灶增强方式、强化程度以及邻近器官受侵情况等。结果子宫癌肉瘤(UCS)43例,35例Ⅰ型UCS病灶最长径1.80~18.34 cm,平均(7.81±3.82)cm,8例Ⅱ型UCS平均内膜厚度为(17.41±10.30)mm。17例Ⅰ型UCS以实性成分为主,多表现为宫腔内被充填的肿块,边界不清,包膜不完整,密度不均匀,12例以囊性成分为主,6例表现为完全实性。实性成分强化程度较子宫肌层低,多呈渐进性或持续性中度强化,内可见增粗血管影或血管流空信号,合并盆腔积液少见,多侵犯子宫肌层。卵巢癌肉瘤(OCS)14例,瘤体最长径4.26~18.34 cm,平均(11.20±3.99)cm,大多数病灶以囊性成分为主,形状不规则,边缘欠清晰,实性成分多呈渐进性中度强化,病灶周围可见明确侵犯征象以及少至大量腹水。结论女性生殖系统CS在CT和MRI上具有一定的特征,与UCS相比,OCS易有邻近器官的侵犯和转移。CT和MRI的作用在于观察肿瘤邻近器官、组织的侵犯、有无盆腔积液以及腹膜、淋巴结转移,为其临床分期提供重要依据。Objective To investigate the CT and MRI features of carcinosarcoma(CS)of the female reproductive system.Methods The clinical and imaging data of patients with CS of female reproductive system which were confirmed by pathology were collected retrospectively.A total of 57 patients were included.The location,number,shape,size,edge,capsule,density or signal of the lesions were observed and evaluated,and the enhancement mode,enhancement degree and invasion of adjacent organs were analyzed.Results There were 43 cases of uterine carcinosarcoma(UCS).The longest diameter of type ⅠUCS in 35 cases ranges from 1.8 cm to 18.34 cm,and the average was(7.81±3.82)cm.The average intimal thickness of type Ⅱ UCS in 8 cases was(17.41±10.30)mm.17 cases of type Ⅰ UCS were mainly solid,and most of them were filled with masses in uterine cavity,with unclear boundary,incomplete capsule and uneven density;12 cases were mainly cystic components and 6 cases were completely solid.The enhancement degree of solid components was lower than that of myometrium,and most of them showed progressive or persistent moderate enhancement,in which thickened vascular shadow or vascular flow void signal could be seen,pelvic effusion was rare,and most of them invaded myometrium.There were 14 cases of ovarian carcinosarcoma(OCS).The longest diameter of the tumor ranges from 4.26 cm to 18.34 cm,and the average was(11.20±3.99)cm.Most of the lesions were mainly cystic components,irregular shape,unclear edges,gradual moderate enhancement of solid components.Clear signs of invasion around the lesions and little to large amount of ascites were also been observed.Conclusion Female reproductive system CS has certain characteristics on CT and MRI.Compared with UCS,OCS is prone to invasion to adjacent organs and distant metastasis.CT and MRI play a more important role in observing the invasion of adjacent organs and tissues,pelvic effusion,peritoneal and lymph node metastasis,which provide an important basis for clinical staging.

关 键 词：癌肉瘤 生殖系统 计算机体层成像 磁共振成像 

分 类 号：R737.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]