子宫内膜癌的MRI诊断

MRI diagnosis of endometrial carcinoma of uterus

目的 :探讨子宫内膜癌的MRI表现特征 ,进一步提高该病诊断符合率。方法 :回顾性分析 3 0例完整的子宫内膜癌的MRI资料。MRI检查前 2 9例经诊断性刮宫病理检查确诊 ,仅 1例疑诊。MRI检查后 2～ 9d内手术。术式均为全宫切除术 ,手术标本送病理检查。结果 :① 13例表现为整个子宫不同程度增大。② 14例表现为宫腔增大 ,7例病灶局限在粘膜内 ,子宫肌层正常。宫腔粘膜加上腔内液体的厚度为 1.5～ 2 .7cm ,在增强后脂肪抑制序列上单纯的粘膜厚度为 0 .3～0 .5cm。③ 10例为浅肌层侵犯 ,13例为深肌层侵犯 ,5例伴有宫颈管的侵犯。④盆腔窃血征 13例。⑤盆腔淋巴结及附件受累 4例。结论 :MRI检查能准确显示病变范围、肌层受侵深度和盆腔淋巴结转移情况。

Objective:To investigate the MR features of endometrial carcinoma of uterus in order to improve the diagnostic accuracy.Methods:The MR features of 30 patients with endometrial carcinoma were retrospectively analyzed,including 29 diagnosed pathologically through diagnostic uterine curettage and 1 diagnosed clinically.Operative treatment (uterectomy) was made from 2 to 9 days after MR examination and all specimen were examinated by pathology.Results:13 cases showed enlargement of entire uterus in varying degrees.14 cases showed enlargement of uterine cavity,only the mucosa was invaded and the muscular layer was normal.The thickness of uterine mucosa combined with fluid in uterine cavity was 1.5～2.7cm.The thickness of mucosa was 0.3～0.5cm in fat saturated enhanced MR sequence.Superficial muscular layer was invaded in 10 cases and deep muscular layer in 13 cases,and there was uterocervical invasion in 5 cases. ”sign of stealing blood” in pelvic cavity was seen in 13 cases.Pelvic lymph nodes and appendage were involved in 4 cases.Conclusion:MR examination can demonstrate accurately the extension of lesion,invasion of muscular layer and metastases of lymph nodes in pelvic cavity.