巨大子宫肌瘤黏液变性的CT和MRI诊断

CT and MRI diagnosis of giant hysteromyoma with mucoid degeneration

目的探讨CT及MRI对巨大子宫肌瘤黏液变性的表现特征和诊断价值。方法回顾性分析17例经手术和病理证实的巨大子宫肌瘤黏液变性的CT和MRI表现,并将CT和MRI表现与病理结果对照。结果17例肿瘤直径10～30cm之间,左侧阔韧带源性1例,浆膜下来源者3例,肌壁间7例,宫颈部3例,骶前间隙3例。CT显示等密度肿瘤3例,病理证实为肌瘤伴部分区域黏液变性;混杂密度肿瘤7例,病理证实为广泛黏液性变性。MRI显示肌瘤T_1WI、T_2WI以等信号为主者4例;T_1WI呈等信号,T_2WI呈等高混杂信号者1例;T_1WI以稍低信号为主,T_2WI呈高低混杂信号者5例。结论CT对巨大子宫肌瘤的诊断具有一定价值,MRI对巨大子宫肌瘤的来源及女性盆腔巨大肿块的鉴别有重要价值。

Objective To evaluate of CT and MRI in giant hysteromyoma and to recognize the characteristics of giant hysteromyoma with mucoid degeneration. Methods Seventeen cases of giant hysteromyma with mucoid degeneration proved by surgery and pathology were reviewed .All cases had CT plain and enhanced scaning or MRI scaning.Imaging features,surgical findings and pathological results were analyzed. Results The maximal diameter of the hysteromyoma ranged from 10cm to 30cm. One case located the left broad ligament. 3 cases located subserousa of uterus. 7 cases located myometrium. 3 cases located the uterus cervix. 3 cases demonstrated homogeneous density similar to normal uterus tissue on CT scans. Pathology proved hysteromyoma with partial mucoid degeneration.In the other 7 cases, the giant mass demonstrated heterogeneous density cases showed relatively isointense on both T1- and T2-weighted Pathology proved hysteromyoma with broad mucoid degeneration.4 images.One case showed isointense signal intensity on T1WI and heterogeneous hyperintense on T2WI. In the other 5 cases, T1WI showed hypointense mass and T2WI showed inhomogeneous signal intensity. Conclusion CT is useful in the diagnosis of the giant hysteromyoma with dengeneration. MRI provides useful information for determining the origin of giant hysteromyoma and has definitive value in discrimination of large pelvic tumors arising in females.