宫颈平滑肌瘤的不典型磁共振成像表现与病理分析  

Atypical MRI findings and pathological analysis of cervical leiomyoma

作　　者：卫莎莎 刘艳玲[1] Wei Shasha;Liu Yanling(Department of Radiology,Anyang District Hospital,Henan 455000,China)

机构地区：[1]河南省安阳地区医院放射科,455000

出　　处：《实用医学影像杂志》2023年第4期298-301,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨宫颈平滑肌瘤的不典型磁共振成像(MRI)表现与病理特征。方法搜集本院2016年3月至2021年12月经手术和病理证实的7例宫颈不典型平滑肌瘤患者的临床、MRI和病理资料,2例行MRI增强扫描,回顾性分析其MRI表现及病理学特征。结果1例为宫颈环壁生长型病灶,6例为宫颈单发肿块型病灶,其中3例肿块巨大,直径>10 cm。位于宫颈肌壁间4例,可见深达黏膜下的粗蒂与肌层相连;浆膜下2例,浆膜层受压向侧后方移位。位于宫颈前壁1例,后壁4例,侧壁1例。1例环壁生长型肌瘤表现为宫颈肥大,肌层明显增厚,呈T_(1)加权成像(T_(1)WI)等信号,T_(2)加权成像(T_(2)WI)低信号;2例富细胞性平滑肌瘤表现为T_(1)WI等信号T_(2)WI稍高信号,信号较均匀,增强扫描呈渐进性明显强化;4例伴不等量黏液变性的平滑肌瘤表现为T_(1)WI等信号T_(2)WI低信号,肿块内可见T_(1)WI低信号T_(2)WI高信号的黏液组织。结论宫颈不典型平滑肌瘤极少见,其生长方式与病理类型复杂,MRI在其诊断和鉴别诊断方面有独特的优势。Objective To investigate the atypical MRI features and pathologic features of cervical leiomyoma.Methods The clinical,MRI and pathological data of 7 patients with cervical atypical leiomyoma confirmed by surgery and pathology in our hospital from March 2016 to December 2021 were collected,and 2 patients underwent MRI enhanced examination.Results One case had a ring wall growing lesion of the cervix,and 6 cases had single cervical mass lesions,among which 3 cases had large masses with a diameter of>10 cm.The lesions of 4 cases were located between the cervical muscle wall and had a thick pedicle connected with the myometrium,which reached deep under the mucous membrane.The lesions of 2 cases were subserosal and the serous membrane shifted backward or laterally under pressure.The lesions of 1 case was located in the anterior cervical wall,and the lesions of 4 cases in the posterior wall,and the lesions of 1 case were in the lateral wall.One case′s ring wall growth myoma showed hypertrophy of the cervix and obvious thickening of the myometrium with an equal signal on T_(1)WI and low signal intensity on T_(2)WI.Two cases with cell-rich leiomyoma showed equal signals on T_(1)WI and slightly higher signals on T_(2)WI,with more uniform signals and progressive and obvious enhancement in enhanced scan.Four cases′leiomyoma with unequal myxoid degeneration showed equal signals on T_(1)WI and low signals on T_(2)WI,and low signal on T_(1)WI and high signal on T_(2)WI were found in the mass.Conclusion Atypical leiomyoma of the cervix is rare,and their growth patterns and pathological types are complex.MRI has unique advantages in their diagnosis and differential diagnosis.

关 键 词：宫颈 平滑肌瘤 磁共振成像 病理 

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