多排螺旋CT子宫动脉血管成像术在子宫肌瘤诊断中的应用及影像特点

目的探究多排螺旋CT(MSCT)子宫动脉血管成像应用于子宫肌瘤术前诊断的临床价值。方法回顾性分析68例子宫肌瘤患者(92枚)临床资料,以栓塞术中数字血管减影造影(DSA)为"金标准",比较不同类型肌瘤MSCT影像特征差异,分析术前MSCT子宫动脉血管成像诊断肌瘤供血动脉的准确性。结果MSCT影像中,三种肌瘤肿块低密度、动脉分支增粗出现率比较均无统计学意义(均P>0.05),而浆膜下肌瘤囊变/液化出现率明显高于肌壁间肌瘤与黏膜下肌瘤(均P<0.05),肌壁间肌瘤不均匀强化、血管网包绕出现率明显高于浆膜下肌瘤与黏膜下肌瘤(均P<0.05)。MSCT子宫动脉血管成像诊断肌瘤供血动脉灵敏度为81.81%,特异度为81.25%,准确度为81.52%。结论MSCT子宫动脉血管成像术能在早期较为准确诊断肌瘤供血动脉,可为栓塞术提供丰富的影像信息,有较高临床应用价值。

Application and Imaging Features of Multislice Spiral CT Uterine Artery Angiography in the Diagnosis of Uterine Fibroids

Objective To explore the clinical value of multi-slice spiral tomography(MSCT)uterine artery angiography in the preoperative diagnosis of uterine fibroids.Methods The clinical data of 68 patients with uterine fibroids(92 fibroids)were retrospectively analyzed.The digital substraction angiography(DSA)of embolization was used as the gold standard to compare the MSCT images features among different types of fibroids.The accuracy of MSCT uterine artery angiography was analyzed in the preoperative diagnosis of fibroid feeding arteries.Results In MSCT images,there were no statistically significant differences in the incidence rates of mass low density and arterial branches thickening among the three fibroids(P>0.05),and the incidence rate of cystic changes/liquefaction of subserosal fibroids was significantly higher than that of intramural fibroids and submucosal fibroids(all P<0.05),and the incidence rates of uneven enhancement and vascular network wrapping of intramural fibroids were significantly higher than those of subserosal fibroids and submucosal fibroids(all P<0.05).The sensitivity,specificity and accuracy of MSCT uterine artery angiography in the diagnosis of fibroid feeding arteries were 81.81%,81.25%and 81.52%.Conclusion MSCT uterine artery angiography can accurately diagnose fibroids in the early stage,and it can provide rich image information for embolization and it has high clinical application value.