巨大浆膜下子宫肌瘤的CT与MRI诊断

目的:探讨巨大浆膜下子宫肌瘤(giant subserous hysteromyoma,GSH)的CT与MRI表现,以期提高诊断水平。方法:回顾性分析15例GSH的CT平扫、增强扫描及14例MRI平扫1、0例增强扫描表现并与手术病理结果对照。结果:5例CT表现呈非均匀实性的GSH在增强后内部呈多个大小不等的结节状改变,其间可见分隔结构,4例呈非均匀实性的GSH增强后呈"漩涡状"混杂密度,3例GSH瘤体边缘见低密度带。MRI T1WI所有肌瘤表现为等、低信号,T2WI表现为低或混杂信号,5例瘤体内部为结节状改变,其间可见高信号分隔结构,7例瘤体边缘见低信号带。结论:GSH的CT与MRI表现有一定的特征性,具有较高的诊断价值。

CT and MRI diagnosis of giant subserous hysteromyoma

Objective:To explore the CT and MRI findings of giant subserous hysteromyoma(GSH) so as to improve diagnostic accuracy.Methods:15 cases of CT and MRI of giant subserous hysteromyoma proved by surgery and pathology were reviewed.CT plain and enhanced scanning were performed in all cases;MRI were performed in 14 cases,of which 10 cases were performed with contrast enhancement.Results:The lesions presented as inhomogeneous solid(n=11),homogeneous solid(n=3),cystic-solid(n=1).Solid hysteromyoma appeared multiple nodules and the septa were inhomogeneous density after contrast enhancement(n=7),the vortex-like mixed density area were shown within the inhomogeneous solid hysteromyoma(n=4),the peritumor rim appeared as low density in hysteromyoma(n=3). All lesions presented as intermediate or low signal intensity on T1-weighted images,low or heterogeneous signal intensity,6 lesions were consisted of multiple nodules and the hyperintensity septa as linear structures,the peritumor rim appeared as low signal intensity in 7 lesions.Conclusion:CT findings of giant subserous hysteromyoma provide some characteristics.It should be paid special attention to distinguish giant subserous hysteromyoma from primary mesenteric tumors and gastrointestinal stromal tumors.