子宫肌瘤的CT诊断

CT Diagnosis of Uterine Leiomyomas

目的：总结子宫肌瘤的ＣＴ特证，讨论其应用价值。材料与方法：分析３８例经手术病理证实为子宫肌瘤的ＣＴ征象，对横断面上显示病变大小、位置与宫腔关系及病变的强化进行评价。结果：３８例中除１例误诊为子宫内膜癌外，ＣＴ都确诊为子宫肌瘤，其ＣＴ诊断准确率为９７３％。其中浆膜下型１０例，壁间型１８例，粘膜下型２例，混合型８例。全部病例子宫均有不同程度增大；肌瘤表现为低密度或等密度的实质性肿块，边界清楚。较大的肌瘤可有低密度坏死灶。钙化灶３例，占７９％。增强扫描肌瘤与正常肌层相差５～１０ＨＵ。结论：ＣＴ在显示子宫肌瘤的大小、位置与宫腔关系上有较高的诊断价值。

PURPOSE:To summarize the CT features of uterine leiomyomas and evaluate their value of application.MATERIALS AND METHODS:Analysis the CT scans of 38 cases with uterine leiomyomas proves by operation and pathology, assessment of the sizes and positions of myomas, their relationship with uterine cavities and their enhancement in transections.RESULTS: All cases were confirmed as leiomyomas by CT except 1 was falsely diagnosed as carcinoma of endometrium. The accuracy of CT diagnosis was 97 3%. In all cases, 10 were subserous myoma, 18 were intramural myoma, 2 were submuous myoma, 8 were multiple myomata of uterus. All cases showed that uterus enlarged to a greater of lesser degree. Leiomyomas showed well circumscribed material masses with low or equal density. The larger myomas may have low density necrosis. There were calcification in 3 cases, which accounted 7 9%. The difference between the leiomyomas and the normal myometrium was 5 to 10HU by contrast scan. CONCLUSION: CT shows great value in diangosing the sizes and positions of leiomyomas and their relationship with uterine cavities. It can serve as an important secondary method to uttrasound.