腹膜播散性平滑肌瘤病CT及MRI表现  

CT and MRI manifestations of leiomyomatosis peritonealis disseminata

作　　者：邝菲 韩海伟[1] 蓝岚[1] 彭晨钰 吴秀蓉[1] KUANG Fei;HAN Haiwei;LAN Lan;PENG Chenyu;WU Xiurong(Department of Radiology,the First Affiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属第一医院放射科,福建厦门361000

出　　处：《中国医学影像技术》2022年第3期408-412,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察腹膜播散性平滑肌瘤病(LPD)的CT及MRI表现。方法回顾性分析9例经手术或穿刺病理证实的LPD患者,观察其CT及MRI表现,测量并比较LPD与子宫肌层平扫CT值,增强CT动脉期强化率、静脉期强化率、延迟期强化率及表观弥散系数(ADC)差异。结果LPD病灶均为多发,部分呈粟粒状;1例仅见盆腔病灶(伴子宫肌瘤),1例病变局限于腹腔,7例腹、盆腔均见病灶;6例伴网膜种植,5例伴子宫旁结节;最大病灶长径约15 cm,多发病灶长径均<1 cm(最小病灶长径约0.5 cm);其边界清晰,边缘光滑、锐利,周围脂肪间隙较清晰;病变均未累及实质器官,未见明显肿大淋巴结。平扫CT 7例表现为密度均匀的实性结节或团块,2例伴囊性成分;实性部分CT值[(39.12±10.18)HU]与子宫肌层相仿[(43.28±11.13)HU,t=0.32,P=0.79],增强CT动脉期、门静脉期及延迟期强化率与正常子宫肌层差异均无统计学意义(P均>0.05);囊性成分平扫CT值(16.23±4.12)HU,增强后未见明显强化。7例接受MRI,实性成分6例T2WI呈低信号、1例呈高信号;DWI上实性成分呈等或略低信号,囊性成分呈低信号;ADC图上实性成分呈等信号,囊性成分呈高信号,实性成分ADC[(1.21±0.19)×10^(-3) mm^(2)/s]与正常子宫肌层差异无统计学意义[(1.35±0.17)×10^(-3) mm^(2)/s,t=0.45,P>0.05];增强后病灶实性成分均表现为渐进性强化。结论LPD的CT及MRI表现具一定特征性,结合病史有助于诊断。Objective To observe the imaging manifestations of leiomyomatosis peritonealis disseminate(LPD).Methods Nine patients with LPD confirmed by pathology were retrospectively analyzed.CT and MRI manifestations of LPD were observed,and the CT values with plain scan of LPD and myometrium,as well as CT enhancement rate in arterial phase,in venous phase,in delayed phase and apparent diffusion coefficient(ADC)were measured and compared.Results Multy lesions were found in all 9 cases,some lesions diffusedly distributed.The lesions located only in the pelvic cavity(accompanied with uterine fibroids)in 1 case,in the abdominal cavity in 1 case,in both pelvic and abdominal cavity in the other 7 cases.Among 9 cases,6 were associated with omental implantation and 5 with parauterine nodules.The length of the largest lesion was about 15 cm,and the length of multiple nodules was less than 1 cm(the length of the smallest lesion was about 0.5 cm),with clear boundary,smooth and sharp edge,and the surrounding fat gap was clear.No parenchymal organ invasion nor obvious swollen lymph node was detected.Solid nodules or masses with uniform density were found in 7 cases,while lesions with cystic components were observed in 2 cases.The CT value with plain scan of solid components of lesions([39.12±10.18]HU)was similar to that of myometrium([43.28±11.13]HU,t=0.32,P=0.79).There was no significant difference of CT enhancement rate of arterial phase,portal vein phase nor delayed phase between solid components of LPD lesions and normal myometrium(all P>0.05),both showed progressive enhancements.The CT value with plain scan of cystic component sof LPD was(16.23±4.12)HU,and no obvious enhancement was observed.Among 7 patients underwent MRI,low signal intensity on T2WI was detected in 6 cases,while high signal intensity in 1 case.On DWI,solid components of LPD lesions showed equal or slightly lower signals,while cystic components showed low signals.No significant difference of ADC was found between solid components of LPD lesions([1.21±0.19]×10

关 键 词：腹膜肿瘤 诊断显像 平滑肌瘤病 

分 类 号：R735.5[医药卫生—肿瘤] R445[医药卫生—临床医学]