子宫癌肉瘤的CT及MRI增强特征分析  

Analysis of the CT and MRI enhancement characteristics of uterine carcinosarcoma

作　　者：公维云 盛蕾[1] 苏慧 朱晓琳[1] 王立民 GONG Weiyun;SHENG Lei;SU Hui;ZHU Xiaoin;WANG Limin(Department of Medical Imaging Center,Taian Central Hospital,Affiliated Hospital of Qingdao University,Taian 271000,China)

机构地区：[1]青岛大学附属泰安市中心医院医学影像中心,山东泰安271000

出　　处：《医学影像学杂志》2024年第7期93-96,100,共5页Journal of Medical Imaging

摘　　要：目的 探讨子宫癌肉瘤的CT及MRI增强检查的影像学特点,以提高对子宫癌肉瘤的影像学认识。方法选取经活检或手术病理证实的32例子宫癌肉瘤患者,其中15例行CT平扫及增强检查,17例行MRI平扫及增强检查,总结子宫癌肉瘤的发病年龄、病变形态、强化方式、囊变出血坏死情况及是否有异常血管影、肌层受侵情况的影像学特点。按肿瘤最大径(Dmax≥5 cm和Dmax<5 cm)分成两组,Dmax≥5 cm组15例,Dmax<5 cm组17例,两组平均年龄分别为(61.1±10.2)岁、(59.8±9.2)岁;并对其CT及MRI检查表现征象及增强特征进行统计学分析。结果 32例均为单发,8例局限性、24例弥漫性,轻度强化10例,22例不均匀明显强化;流入型强化方式(26例)较流出型(6例)多见;24例伴囊变坏死或出血;CT检查1例显示病变内多发点状钙化,9例显示异常血管影。Dmax≥5 cm组和Dmax<5 cm组病变生长方式、侵及肌层程度、有无囊变坏死及出血情况、盆腔有无增大淋巴结比较,差异有统计学意义(P<0.05),而在异常血管影的显示及强化程度、强化方式差异无统计学意义(P>0.05)。结论 CT及MRI增强检查对子宫癌肉瘤的诊断具有较大的应用价值。Objective To explore the imaging features of CT and MRIenhanced examination of uterine carcinosarcoma in or‐der to improve the imaging understanding of uterine carcinosarcoma.Methods The imaging data of 32 cases of uterine carci‐nosarcoma confirmed by biopsy or surgical pathology(15 cases with CT plain scan and enhanced scan and 17 cases with MR plain scan and enhanced scan)were selected,and the imaging characteristics of the age of onset,lesion morphology,en‐hancement mode,cystic hemorrhage and necrosis,abnormal vascular shadow,and muscular invasion were summarized.The tumors were divided into two groups according to the maximum diameter(Dmax≥5 cm and Dmax<5 cm).In the group of Dmax≥5 cm,there were 15 cases and in the group ofDmax<5 cm,there were 17 cases,the mean age was(61.1±10.2)years old and 59.8±9.2 years old in those two groups respectively.The CT and MRI signs and enhancement characteristics were statistically analyzed.Results All 32 cases were single.8 cases(8/32)were localized and 24 cases(24/32)were diffuse.There were 10 cases(19/32)with mild enhancement and 22 cases(22/32)with uneven enhancement.Inflow reinforcement was more common in 26 cases(26/32)than outflow reinforcement in 6 cases(6/32).There were 24 cases(24/32)with cystic necrosis or hemorrhage.Multiple punctate calcification was detected by CT in 1 case(1/15).Abnormal vascular shadow was found in 9 cases(9/32).There were statistically significant differences in lesion growth pattern,degree of invasion of muscle layer,cystic necrosis and hemorrhage,and pelvic lymph node enlargementbetween Dmax≥5 cm and Dmax<5 cm groups(P<0.05).There was no statistical difference in the display of abnormal vascular shadow,the degree of enhancement and the way of enhancement(P>0.05).Conclusion CT and MRI enhanced examination is of great value in the diagnosis of uterine carci‐nosarcoma.

关 键 词：子宫癌肉瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R737.33[医药卫生—肿瘤] R814.42[医药卫生—临床医学]