盆腔侵袭性血管黏液瘤的CT与MRI表现和诊断  

Value of CT and MRI in the Diagnosis of Pelvic Aggressive Angiomyxoma

作　　者：卢红 吴宗乾 陈家飞 胡晓飞 陈伟 LU Hong;WU Zongqian;CHEN Jiafei;HU Xiaofei;CHEN Wei(Department of Radiology,First Affliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院放射科,重庆400038

出　　处：《中国医学计算机成像杂志》2022年第5期522-526,共5页Chinese Computed Medical Imaging

摘　　要：目的:分析盆腔侵袭性血管黏液瘤(AAM)的CT与MRI影像学特点,并探讨其在影像诊断中的价值。方法:搜集2000—2021年经我院病理证实的11例AAM,男性1例,女性10例,年龄12~47岁,中位年龄32.7岁。回顾性分析其CT、MRI影像学表现。结果:11例均为单发,病灶直径约6~28cm,平均约14cm,球形、哑铃状2例,5例病灶形态不规则,沿盆腔及会阴区脂肪间隙生长,类似长柱形4例。其中7例肿瘤上下径明显大于左右径及前后径。CT平扫肿块表现为低密度,增强扫描多表现为轻度强化,3例(38%)可见分层状强化;MRI T1WI上,AAM以稍低信号为主,T2WI均呈不均匀高信号,4例(50%)可见分层状表现;7例增强MRI检查,肿块均呈持续性、明显强化,其中4例(57%)可见分层状强化。弥散加权成像(DWI)及表观弥散系数(ADC)图像均显示为高信号。结论:AAM在CT平扫多表现为低密度,增强扫描轻度强化,MRI T2WI及DWI、ADC均表现为高信号,增强扫描呈持续性、明显强化。“分层漩涡征”具有一定特征性,有助于术前正确诊断。Purpose:To analyze the CT and MRI image features of pelvic aggressive angiomyxoma(AAM),and to explore its clinical value in the diagnosis of AAM.Methods:From 2000 to 2021,11 cases of AAM confirmed by pathology in our hospital were collected,including 1 male and 10 female,aged from 12 to 47 years,with a median age of 32.7 years.CT and MRI findings were analyzed retrospectively.Results:All 11 cases were solitary,the diameter of the lesion was about 6-28 cm,the average diameter was about 14 cm,2 cases were spherical and dumbbell shape,5 cases were irregular in shape,growing along the fat gap in the pelvic cavity and perineum,4 cases resembled as a long column;In 7 cases,the upper-lower diameters of the tumors were significantly larger than the left-right diameters and the anteroposterior diameters.CT plain scan showed mass was low density mass,and enhanced scan mostly showed mild enhancement,3 cases(38%)showed layered enhancement;On MRI T1WI,AAM was mainly with slightly low intensity signal,T2WI showed uneven high intensity signal,4 cases(50%)were shown with layered manifestations;7 cases of enhanced MRI showed continuous and obvious enhancement,of which(57%)cases showed layered enhancement.Both diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)images show high intensity signal.Conclusion:AAM showed low density on CT plain scan,slight enhancement on enhanced scan,high signal on MRI T2WI,DWI and ADC,and continuous and obvious enhancement on enhanced scan.The"stratified vortex sign"has certain characteristics,which is helpful for correct diagnosis before operation.

关 键 词：侵袭性血管黏液瘤 盆腔肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学]