低场MRI对诊断子宫肌瘤与子宫腺肌病的应用价值

目的分析子宫肌瘤与子宫腺肌病的MRI表现特点，探讨MRI对两病的诊断价值。方法回顾性分析25例经手术病理证实的子宫肌瘤和子宫腺肌病患者MRI资料。结果16例子宫肌瘤患者中，共检出病灶24个。T1WI表现均为等低信号，不易识别；T2WI表现为低、高或混杂信号；病灶多有包膜、边界清晰，周围可见低或高信号环；增强扫描可见病灶不同程度强化。7例子宫腺肌病中，弥漫性5例、局限性2例。T1WI及T2WI信号不均，T2WI表现结合带弥漫性或不规则增厚，结合带改变具有诊断特异性；病灶无包膜与周围组织界线不清；增强扫描无明显强化，为等或低信号：2例为子宫肌瘤合并子宫腺肌病。T2WI及增强扫描有助于两病的显示及鉴别诊断。1例子宫肌瘤误诊为子宫腺肌病，1例子宫腺肌病误诊为子宫肌瘤，MRI对两病诊断的敏感性100％，准确率92％。结论选择合适的MRI检查序列与方法对两病鉴别诊断只有重要的价值。

The utility of low field MRI for diagnosing uterine leiomyoma and adenomyosis

Objective to analyze the MRI findings of uterine leiomyoma and adenomyosis and to evaluate their value in the diagnosis of the two diseases. Methods MRI data of 25 patients with surgically and pathologieally proved uterine leiomyoma and adenomyosis were analyzed retrospectively. Results Amnng 16 patients with uterine leinmynma,total 24 lesions were deteeted by MRI,which were hypointensity on T1WI and were difficult of resolution;on T2WI ,the lesions were hypointensity,hyperintensity nr heterogeneous signals;the most lesions had encapsulated membrane and well -defined margin surrounded by low or high signal circles;the lesions were mnre or less enhaneed after the administration of contrast medium. Among 7 patients with adenomyosis＇diffuse and loeal lesions were found in 5 and 2 case,respectively,which were non-homogeneous signals on T1WI and T2WI.The diffuse or irregular thickening of the junctional zone visible on T2WI could be considered to have diagnostic specificity;the lesions laeked encapsulated membrane and were ill-defined margin with surrounding tissues; the lesions were not obvious enhancement on enhanced images,which were isointensity or hypointensity. The remainder two eases were coexistence of uterine leiomyoma and adenomyosis.T2WI and contrast-enhanced scanning were helpful to visualize and to differentiate the two diseases.One patient with uterine leiomyoma was misdiagnosed as adenomyusis, while one patient with adenomyosis was misdiagnnsed as uterine leiomyoma.The sensitivity and accuracy of MRI for the two diseases was 100% and 92%, respectively. Conclusion Selecting the proper MRI sequenee and modality is very important to differentiate uterine leiomyoma from adennmynsis.