子宫肉瘤的CT及MRI影像学表现  

CT and MRI Imaging of Uterine Sarcomas

作　　者：张晓燕 徐晨 曲倩倩 周萍[4] 徐瑜 邓凯[1] ZHANG Xiao-yan;XU Chen;QU Qian-qian;ZHOU Ping;XU Yu;DENG Kai(Department of Radiology,the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital),Jinan 250014,Shandong Province,China;Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan 2500024,Shandong Province,China;School of Clinical Medicine,Jining Medical University,Jining 272067,Shandong Province,China;Department of Pathology,the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital),Jinan 250014,Shandong Province,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)放射科,山东济南250014 [2]山东第一医科大学(山东省医学科学院),山东济南250024 [3]济宁医学院临床医学院,山东济宁272067 [4]山东第一医科大学第一附属医院(山东省千佛山医院)病理科,山东济南250014

出　　处：《中国CT和MRI杂志》2024年第6期130-132,共3页Chinese Journal of CT and MRI

基　　金：山东省医药卫生科技发展计划项目(2016WS0505)。

摘　　要：目的 分析并总结子宫肉瘤的CT及MRI影像表现。方法 回顾性分析15例经病理及手术证实为子宫肉瘤患者的临床特征、CT及MRI表现,总结并探讨其特征性影像学表现。结果 15例子宫肉瘤患者中包括子宫平滑肌肉瘤患者8例,其中4例病灶局限于宫腔内,4例表现为盆腔巨大包块,8例病灶均呈囊实性包块;未分化子宫肉瘤1例,呈类圆形短T_(1)、长T_(2)信号,边界清,DWI呈边缘环形高信号;子宫腺肉瘤2例,表现结节状、团块状混杂密度病灶,增强扫描呈明显不均匀强化;低级别子宫内膜间质肉瘤3例,均呈T_(1)WI等或低信号、T_(2)WI高或稍高信号且DWI呈明显高信号;高级别子宫内膜间质肉瘤1例,表现为盆腔内巨大囊实性占位,病理证实病灶侵穿浆膜累及局部肠壁浆膜下组织。结论 子宫肉瘤常表现为盆腔内囊实性包块,体积较大,形态不规则,可侵犯邻近结构或发生远处转移。MRI表现较具有特征性,常表现为等或稍长T_(1)WI、混杂长T_(2)WI信号,DWI呈高或略高信号,增强扫描肿块呈明显不均匀强化。Objective To summarize and analyze the CT and MRI imaging manifestations of uterine sarcomas.Methods the clinical features,CT and MRI images of 15 patients diagnosed by surgery and pathology were analyzed retrospectively,and their characteristic manifestations were summarized and discussed.Results The 15 patients with uterine sarcomas included 8 patients with uterine smooth muscle sarcoma,4 of which had lesions confined to the uterine cavity,4 presented with large pelvic masses,and all lesions were cystic masses;1 case with undifferentiated uterine sarcoma,the lesion showed short T_(1)WI and long T_(2)WI signal with clear border and it showed a marginal ring-shaped high DWI signal;2 cases of uterine adenosarcoma showed mixed density lesions in the form of nodules and masses,with significant heterogeneous enhancement on enhancement scans;3 cases of low-grade endometrial mesenchymal sarcoma which showed equal or low T_(1)WI and high or slightly high T_(2)WI signal,and they showed significant high DWI signal;1 case of high-grade endometrial mesenchymal sarcoma which showed a large cystic solid occupancy in the pelvis,and pathologic confirmed that the lesion invaded the plasma membrane and involved local subplasma tissue of the intestinal wall.Conclusion Uterine sarcoma often presents as a large cystic mass in the pelvis with indistinct border and irregular shape,which may be accompanied by involvement of adjacent structures.The MRI presentation is characteristic,with equal or slightly low T_(1)WI signal,mixed high T_(2)WI signal,high or slightly high DWI signal,and heterogeneous enhancement of the mass on enhancement scans.

关 键 词：子宫肉瘤 影像学 电子计算机断层扫描(CT) 磁共振成像 病理学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]