子宫内膜息肉与早期子宫内膜癌的MRI信号特征分析

目的 分析子宫内膜息肉与早期子宫内膜癌的特征性MRI平扫表现,以期在无需静脉注射对比剂的情况下,提高两者术前鉴别诊断的准确性。方法 回顾性分析经手术病理证实的39例子宫内膜息肉和32例早期子宫内膜癌病人的MRI资料。采用独立样本t检验比较2组病人病变大小及DWI相对信号强度值。采用Pearson卡方检验分析2组病人MRI平扫信号特征,包括T2WI上病变内部信号特征(低信号纤维核心和高信号小囊),DWI上病变与正常肌层的信号强度差值,T2WI和DWI上病变周围线样高信号。结果与子宫内膜癌相比,子宫内膜息肉T2WI上有高信号小囊和低信号纤维核心表现者更多(P<0.05)。DWI上病变与子宫肌层信号强度差值比较,子宫内膜息肉(36.4±61.7)低于子宫内膜癌(229.8±94.8)(P<0.05)。子宫内膜息肉在T2WI、DWI上的病灶周边线样高信号表现均多于子宫内膜癌(P<0.05)。结论 子宫内膜息肉的MRI表现具有特征性,T2WI及DWI上病变周围线样高信号有助于鉴别子宫内膜息肉与子宫内膜癌。

MRI signal characteristics of endometrial polyps and early endometrial carcinoma

Objective To analyze the characteristic pre-contrast MRI manifestations of endometrial polyps and early endometrial cancer,in order to improve the accuracy of preoperative differential diagnosis between themwithout intravenous contrast agent.Methods The MRI data of 39 cases of endometrial polyps and 32 cases of early endometrial cancer confirmed by operation and pathology were retrospectively collected,and the characteristic pre-contrast MRI appearance were analyzed.The lesions’sizes and DWI relative signal intensities of the two groups were compared using independent sample t-test.The parameters including the internal signal characteristics(low signal fiber core and high signal capsule)and the high signal line around lesions on T2WI;the signal intensity difference between the lesion and normal muscle layer and high signal line around lesions on DWI were analyzed using Pearson χ^2 test.Results Compared with endometrial cancer,there were more cases presenting high signal capsules and low signal fiber core in endometrial polyps on T2WI(P<0.05).The difference insignal intensity between lesions and myometrium on DWI was lower in endometrial polyp(36.4±61.7)than in endometrial carcinoma(229.8±94.8)(P<0.05).The endometrial polyps more frequently presented the high signal line around lesions on T2WI and DWI than endometrial cancer did(P<0.05).Conclusion MR findings of endometrial polyps are characteristic.The high signal line around lesions on T2WI and DWI is helpful in differentiating endometrial polyps from endometrial cancer.