子宫平滑肌瘤病的临床分析及影像学特点

目的深入分析子宫平滑肌瘤病的临床及MRI特点。方法收集近2016年1月至2018年12月间在我院治疗的6例子宫静脉内平滑肌瘤病患者的临床影像学资料,分析肿瘤形态、位置、大小、信号及强化方式、DWI信号及ADC值,将研究结果与病理诊断结果进行对比。结果大体观察,所有患者均有子宫形态的改变,多数表现为子宫增大,多数病灶仅局限在子宫内。免疫组化实验显示平滑肌分化标志物全部呈现阳性,多数激素受体、血管源性标记物阳性。6例均有病灶蠕虫样改变,均发现病灶内流空信号,仅病例3的影像学诊断与病理诊断相符。T1WI呈等信号3例,等高信号3例;T2WI呈高低混杂信号2例,稍高信号2例,混杂高信号1例,等高信号1例。6例肿瘤内部或肿瘤旁可见多发迂曲血管。肿块强化方式均为快进慢出,强化程度除病例2为管状强化,其余均为明显强化。DWI呈高信号2例、稍高信号4例,磁共振ADC值处于正常水平。结论子宫静脉内平滑肌瘤病的临床特异性较差,术前检查的诊断正确率较低。T1WI信号为等或等高,T2WI信号为高或稍高,肿瘤内部或肿瘤旁可见多发迂曲血管。

Clinical Analysis and Imaging Features of Uterine Leiomyomatosis

Objective To in-depth analyze the clinical and MRI features of uterine leiomyomatosis.Methods The clinical image data of 6 patients with uterine leiomyomatosis who treated in our hospital from Janua ry2016 to December 2018 were collected to analyze the tumor morphology,location,size,signal and the enhancement mode,DWI signal,and ADC value,and the research results and pathological diagnosis results were compared.Results In general,all patients had changes in uterine morphology,most of which showed uterine enlargement,and most lesions were confined to the uterus.Immunohistochemistry experiments showed that all markers of smooth muscle differentiation were positive,and most hormone receptors and angiogenic markers were positive.6 cases had worm-like changes in the lesions,and them showed flow-void signs in the lesion.Only the imaging diagnosis of case 3 was consistent with pathological diagnosis.T1 WI showed equal signal in 3 cases,contour signal in 3 cases,T2 WI showed high and low mixed signal in 2 cases,slightly higher signal in 2 cases,a mixed high signal in 1 case,and contour signal in 1 case.Multiple tortuous vessels were seen inside or within the tumor in 6 cases.The lumps strengthening method was intensively fastened and slowed out,except for case 2 was a tubular enhancement,and the rest were markedly enhanced.DWI showed high signal in 2 cases and slightly higher signal in 4 cases,and the magnetic resonance ADC value was at a normal level.Conclusions clinical specificity of uterine leiomyomatosis is poor,and the diagnostic accuracy of preoperative examination is low.The T1 WI signal is high or equal to high,the T2 WI signal is high or slightly higher,and multiple tortuous vessels are visible inside or adjacent to the tumor.