子宫腺肌症合并妇科肿瘤的MRI表现

Adenomyosis associated with gynecologic tumor : Diagnosis with MR imaging

目的:探讨MRI在合并妇科肿瘤的子宫腺肌症中的诊断价值.方法:回顾性分析2003年8月至2004年8月16例子宫腺肌症患者的MRI资料(其中一例为腺肌瘤伴腺肌症).16例患者行快速自旋回波序列(FRFSE)T1WI、T2WI和T1WI抑脂的多期增强快速扰相梯度回波扫描(FSPGR),以矢状面,轴位为主,7例伴有冠状位扫描.所有病例均经手术病理证实.结果:弥漫性子宫腺肌症14例.10例在T2WI上表现为子宫结合带弥漫性增厚,厚度10～37mm,平均17mm,呈均匀的低信号,4例病灶内有散在的点状高信号区,其中1例在T1WI仍表现为高信号.局限性腺肌症(腺肌瘤)3例共3个病灶.在T2WI上,表现为卵圆形、类圆形肿块,呈与结合带信号相近的低信号,直径分别为2cm,4cm,7cm;其中2个病灶与周围肌组织分界不清,1个病灶与周围肌组织有较清楚的界限.3个病灶内均有散在的点状高信号区,其中1个病灶在T1WI也呈高信号区.结论:MRI是发现子宫腺肌症较优越的无创伤性检查方法,T2WI矢状位为最佳扫描序列.

Purpose:To evaluate the value of MRI in the di agnosis of adenomyosis associated with gynecologic tumor. Methods:MR findings in 16 patients with pathologically-proved adenomyosis from Aug,2003—Aug,2004, were retrospectively analyzed. 16 cases und erwent MR scanning, using FRFSE T1WI,T2WI,and contrast enhancement FSPGR T1WI. Results:The lesions in 10 cases with diffuse adenomyosis were d emonstrated as diffusely thickened Junctional Zone(JZ) measuring 10~37mm(mean 17 mm) on T2WI. They were of homogenous low signal intensity. Four had high signal intensity foci with the low signal intensity lesions on T2WI,and these high sign al intensity foci could also be found on T2WI in 1 lesion .3 focal lesions (ade nomyomas) in 3 cases were oval or round masses with low signal intensity that w ere the same as the intensity of JZ on T2WI. They were 2cm ,4cm ,7cm in the diam eter respectively, and two showed ill-defined margins. 3 masses had high signa l intensity foci with the low signal intensity lesions on T2WI and 1 presented high signal intensity on T1WI. Conclusions:MRI is the best modality for the diagnosis of adeno myosis and T2WI is the most useful sequence.