超声对女性生殖系统恶性苗勒管混合瘤的诊断价值  

The value of ultrasound in the diagnosis of malignant mullerian mixed tumors in the female reproductive system

作　　者：付喜玲[1] 周昌荣 张春双 王宝金[1] 牛志军 鲁海燕[1] 栗河舟[1] FU Xi-ling;ZHOU Chang-rong;ZHANG Chun-shuang;WANG Bao-jin;NIU Zhi-jun;LU Hai-yan;LI He-zhou(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院,河南郑州450052

出　　处：《中国临床医学影像杂志》2024年第7期494-497,共4页Journal of China Clinic Medical Imaging

基　　金：河南省科学技术攻关计划(联合共建项目):LHGJ20190371。

摘　　要：目的:探讨女性生殖系统恶性苗勒管混合瘤(MMMT)的超声特征,以期提高对该疾病的诊断水平。方法:回顾性分析2018年1月—2023年7月经我院病理证实的生殖系统MMMT 37例,分析其临床特征并总结其超声征象。37例患者平均年龄56岁,其中32例发生于子宫,4例发生于宫颈,1例发生于卵巢;35例主诉为阴道出血或流液,2例为盆腔包块。结果:术前32例进行了血清CA125检查,8例高于正常,余24例正常。CA125水平与肿块大小及临床分期无相关性。女性生殖系统MMMT彩色多普勒超声具有特征性表现:单发,回声疏松;体积大,平均长径52 mm,其中16例长径大于80 mm。由内部向浆膜层生长,无明显包膜,但可见与正常组织有分界。疏松的不均质中低回声相间分布,呈“小梁样”。肿块较大时内部可见“裂隙样”无回声区,中央区可见中低回声与高回声杂乱分布,呈“蜂窝状”改变;周边血流信号均丰富,肿块较大者中央区血流信号不丰富。结论:女性生殖系统MMMT多发生于子宫,症状多为绝经后阴道流血、流液;彩色多普勒超声具有较为特征性的表现,加强对其特征的认识有助于尽早诊断。Objective:To investigate the ultrasound features of malignant mixed mullerian tumor(MMMT)of the female reproductive system in order to improve the diagnosis of this disease.Methods:The clinical data and ultrasonic manifestations of 37 cases of MMMT diagnosed by pathology in the Third Affiliated Hospital of Zhengzhou University from January 2018 to July 2023 were retrospectively analyzed.The 37 patients were enrolled with an average age of 56 years.Thirty-two cases occurred in the uterus,4 cases in the cervix,and 1 case in the ovaries.Thirty-five cases had symptoms of vaginal bleeding or fluid flow,and 2 cases had symptoms of abdominal distension.Results:The serum CA125 was evaluated in 32 women before operation,8 cases were higher than normal and the remaining 24 cases were normal.There was no significant positive correlation between CA125 level and tumor size and tumor staging.The characteristic features of MMMT color Doppler ultrasound in female reproductive system were as follows:single shot,loose echo;large in size,and the average length was 52 mm,of which 16 cases were larger than 80 mm.Infiltrating growth from the interior to the outside of organs,without clear capsule,but had the boundary with normal tissue.Loose heterogeneous low and medium echoes were interspersed,showing a“trabecular pattern”.When the lesions were large,a“fissure-like”anechoic area,and a“honeycomb”pattern of mixed distribution of low and high echoes in the central area could be seen.The peripheral blood supply of the tumor was abundant,while the central area of larger tumors had less blood supply.Conclusion:MMMT in female reproductive system often occurs in the uterus,and the symptoms are mostly vaginal bleeding and fluid flow in postmenopausal women.The color Doppler ultrasound manifestations of this disease are characteristic.The summary of the ultrasound images is beneficial for the early diagnosis of MMMT.

关 键 词：混合瘤 苗勒 超声检查 多普勒 彩色 

分 类 号：R737.3[医药卫生—肿瘤] R445.1[医药卫生—临床医学]