MRI对子宫肌瘤病理类型的诊断价值

目的：探讨MRI诊断子宫肌瘤病理类型的准确性。方法：对37例子宫肌瘤患者术前行MRI检查，进行MRI分型诊断，与病理诊断进行对照，计算MRI诊断肌瘤病理类型的准确性。结果：37例患者共选取肌瘤40个，MRI正确分型34个，准确率为85％。21个普通未变性肌瘤有2个误诊为富于细胞性肌瘤；9个富于细胞性肌瘤中1个误诊为普通未变性肌瘤；黏液样变性肌瘤3个，红色变肌瘤2个，囊性变肌瘤1个，MRI均诊断正确；2个恶性变肌瘤。MRI正确诊断1个，另1个误诊为富于细胞性肌瘤；透明样变肌瘤2个，由于其MRI表现与普通未变性肌瘤相同而未能作出正确分型。结论：MRI可较准确区分肌瘤变性与否，有助于临床选择保守治疗方案。

The Value of MRI in Identifying Histological Subtypes of Uterine Leiomyomas

Objective: To evaluate the accuracy of MRI in diagnosing uterine leiomyoma histological subtypes. Methods: Thirty-seven patients with uterine leiomyomas accepted pelvic MRI examination before surgery. Leiomyomas were classified based on the MRI findings then compared with the histological diagnosis. The accuracy of MRI in differentiating leiomyoma subtypes was calculated. Results: Forty leiomyomas were selected from thirty-seven patients. The accurately diagnistic subtypes of MRI were thirty-four leiomyomas, the accuracy was 85%. Two leiomyomas of twenty-one that were uncomplicated were misdiagnosed as the cellular. One leiomyoma that was the cellular in nine leiomyomas was misdiagnosed as the common uncomplicated. In the meantime, three myxoid, two hemorrhagic and one cystic leiomyomas were correctly identified by MRI. One of two leiomyosarcomas was correctly diagnosed by MRI, the other was misdiagnose as the cellular. Two hyaline leiomyomas could not be distinguished by MRI since they shared identical appearance with ordinary leiomyomas. Conclusion: MRI is accurate in differentiating between degenerated leiomyomas and uncomplicated ones and can help choose the conservative treatment scheme.