MRI对子宫肉瘤的诊断价值研究

[目的]探讨子宫肉瘤的MRI表现,以提高对该疾病的影像学诊断及鉴别诊断水平。[方法]回顾性分析经手术病理证实的22例子宫肉瘤MRI资料,分析病灶部位、浸润深度、信号特点以及动态增强表现,DWI图信号表现,是否存在出血、坏死或囊变。[结果 ]肿瘤多呈不规则软组织肿块,多数位于宫体（90%）,浸润子宫肌层。病灶T1WI呈等或稍高信号,T2WI表现为混杂高信号。所有病例肿瘤实质均可见动脉期明显强化,并呈持续强化特点。出血及坏死、囊变多见。7例（32%）强化幅度达到或超过子宫肌层,15例（68%）可见网格状强化。9例（40%）病例可见明显强化区内条索状低信号影,呈＂漩涡征＂。DWI呈明显高信号。[结论]子宫肉瘤MRI表现出一定特点,其T2WI信号及动脉增强方式对诊断具有一定意义,结合DWI有助于该疾病的术前诊断。

Diagnostic Value of MRI in Uterine Sarcoma

[Purpose] To investigate MRI findings and to improve the imaging diagnosis and differentiation diagnosis for uterine sarcomas（US）. [Methods] MR images of 22 cases with US pathologically proven were analyzed retrospectively.The MR features of the lesions were analyzed,with emphasis on the location,infiltration,signal intensity and enhancement pattern,DWI features,hemorrhage,cystic degeneration or necrosis. [Results] The tumors were irregular soft tissues,most located in the body of uterus（90%）,myometrium invaded. The MR features were isointense or hyperintense on T1WI,confounding hyperintense on T2WI. All the tumors were highly enhanced in artery phase and presented continued enhancement. Hemorrhage and cystic degeneration or necrosis were always seen. All the tumors were highly enhanced,with 7 cases（32%） isointense or hyperintense to myometrium and 15 cases（68%）hypointense with net like enhancement,9 cases（40%）with grid like shadows which made it ＂whirlpool sign＂. They were hyperintense on DWI. [Conclusion]MRI show some real characteristic of uterine sarcomas in T2WI and the enhancement pattern.It can be helpful to make correct diagnosis before surgery with DWI.