子宫内膜癌的CT诊断价值  

The Value of CT in Diagnosis of Endometrial Carcinoma

作　　者：严建春[1] 胡东劲[1] 张卫东[1] 钱静[1] 郑君[1] 

机构地区：[1]江苏省镇江市第四人民医院CT室,江苏镇江212001

出　　处：《实用放射学杂志》2003年第3期255-257,共3页Journal of Practical Radiology

摘　　要：目的　探讨CT对子宫内膜癌各期的诊断与鉴别诊断价值。方法　 18例子宫内膜癌均经手术和病理证实 ,所有患者均行CT平扫和增强扫描 ,其中中高分化腺癌 11例 ,低分化腺癌 3例 ,鳞腺癌 2例 ,透明细胞癌 1例 ,子宫内膜转移性腺癌 1例。FIGO分期 :Ⅰa期 2例 ,Ⅰb期 3例 ,Ⅱ期 4例 ,Ⅲ期 2例 ,Ⅳ期 5例。结果　子宫内膜癌CT表现为以下特点 :( 1)子宫体积不同程度地增大 ;( 2 ) 18例均可见腔内无强化的均匀水样低密度影 ;( 3) 4例腔内可见乳头状或息肉样突起 ;3例可见半球形软组织突起 ;9例子宫壁肌层局限性或广泛性增厚 ,其中 1/ 2周以上者 6例 ,1/ 2周以下者 3例 ;2例子宫壁肌层基本一致增厚 ;增强后乳头状或息肉样、半球形软组织突起与子宫壁肌层均匀一致强化 ;( 4)Ⅰ期中 2例CT诊断为Ⅱ期 ,1例Ⅱ期CT诊断为Ⅰ期 ,Ⅲ期和Ⅳ期CT均诊断正确。结论　子宫内膜癌CT表现多样化 ,结合临床多能确诊。Objective To study CT diagnostic and differentiating diagnostic value of endometrial carcinoma in different stages.Methods The plain and contrast enhanced CT scanning were performed in 18 patients proved surgically and pathologically before the surgery. Of 18 patients, 11 cases were middle and high-differentiated adenocarcinomas, three low-differentiated adenocareinomas, two adeno-squamous carcinomas, one clear cell carcinoma and one endometrial metastasis. FIGO staging classification were two cases in stage Ⅰa, three Ⅰb, four Ⅱ,two Ⅲ and five Ⅳ. Results CT imaging characteristics including: (1) Uterine volume was enlarged differently; (2) Similar-fluid hypodensity without enhancement were filled in endometrial cavity in all patients; (3) Polypoid or papillary excrescences (four cases) and semi-global mass (three cases) protruding into uterine cavity were enhanced. Partial or broad thickening myometrium were enhanced homogeneously (eight cases>1/2 cycle, three cases<1/2 cycle);(4) Two cases in stage Ⅰ were misdiagnosed as stage I and one case in stage Ⅱ as stage Ⅰ. All of stage Ⅲ and stage Ⅳ cases were diagnosed correctly by CT.Conclusion The CT features of endometrial carcinomas are quite varied. Endometrial carcinoma can be diagnosed accurately combined with clinical dates. Vaginal plug (gauze) before CT scanning is helpful for assessment of cervical invasion.

关 键 词：子宫内膜癌 CT表现 鉴别诊断 临床分期 水样低密度影 

分 类 号：R737.33[医药卫生—肿瘤] R730.44[医药卫生—临床医学]