MRI、经阴道超声对小于3cm的子宫黏膜下肌瘤诊断价值对比  

Comparison on Diagnostic Value of Transvaginal Ultrasonography and MRI for Submucosal Myoma of Uterus Less than 3 cm in Diameter

作　　者：卜岛 韩茜茜[1] BU Dao;HAN Xi-xi(Department of Radiology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院放射科,北京100026

出　　处：《中国CT和MRI杂志》2022年第7期124-125,136,共3页Chinese Journal of CT and MRI

基　　金：北京市科技计划课题(Z161100000116083)。

摘　　要：目的 对比研究经阴道超声检查(TVUS)和MRI检查直径小于3cm的子宫黏膜下肌瘤中的诊断价值。方法 选取本院2016年5月至2018年9月收治且经宫腔镜或病理诊断证实的62例子宫黏膜下肌瘤患者作为研究对象,分析肿瘤部位、大小及形态等影像学特征及阴道超声、MRI检查对子宫黏膜下肌瘤的分型的诊断符合率。结果 子宫黏膜下肌瘤经MRI诊断分型符合率为96.77%,经TVUS诊断分型符合率为83.87%,明显低于MRI检查(P<0.05)。62例患者经阴道超声检查显示子宫增大,形态不规则,宫内回声改变,均可见子宫内膜缺损,内膜下肌层可见低回声或中等回声结节突向宫腔,回声均匀者54例,回声不均匀者8例;11例可见假包膜,后壁回声衰减。宫颈线位置明显偏移,CDFI可见周边环状血流信号。MRI扫描T1WI上呈稍低或等信号,T2WI上呈典型的低信号。6例发生囊变、坏死。结论 MRI与TVUS均可有效显示直径小于3cm的子宫黏膜下肌瘤的影像学特征,但MRI检查可显著提高子宫黏膜下肌瘤的诊断符合率,临床应用价值更高。Objective To compare the diagnostic value of transvaginal ultrasonography(TVUs) and MRI for submucosal myoma of uterus less than 3 cm in diameter. Methods 62 patients with submucosal myoma admitted to our hospital from May 2016 to september 2018 and confirmed by hysteroscopy or pathological diagnosis were selected as the research objects. The imaging features of tumor location, size and morphology were analyzed, and the diagnostic accuracy of transvaginal ultrasonography and MRI in the classification of submucosal myoma was analyzed. Results The diagnostic accuracy of MRI in the classification of submucosal myoma was 96.77%, and the diagnostic accuracy of TVUs in the classification of submucosal myoma was 83.87%, which was significantly lower than that of MRI(P<0.05). The transvaginal ultrasonography showed enlarged uterus, irregular shape, and changes of intrauterine echo in 62 patients. Endometrial defects can be seen,and hypoechoic or moderate echo nodules protruded into uterine cavity in intimal myometrium. There were 54 cases with homogeneous echoes and 8 cases with non-uniform echoes. The pseudocapsule was seen in 11 cases, and the echo of the back wall was attenuated. The position of the cervical line was significantly shifted, and CDFI showed peripheral circular blood flow signal. The MRI scan showed slightly lower or equal signal on T1WI and typical low signal on T2WI. 6 cases showed cystic degeneration and necrosis. Conclusion Both MRI and TVUs can effectively display the imaging characteristics of submucosal myoma less than 3 cm in diameter, but MRI examination can significantly improve the diagnostic accuracy for submucosal myoma and has higher clinical application value.

关 键 词：子宫黏膜下肌瘤 阴道超声 MRI检查 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]