子宫良性肿瘤的MRI检查和诊断

MR Examination and Diagnosis of Benign Uterine Tumors

目的：分析各种子宫良性肿瘤ＭＲＩ 图像，探讨ＭＲＩ 在子宫良性肿瘤中的诊断价值。材料和方法：共收集本院１９９４ － １９９９ 年临床疑子宫良性肿瘤病人３９ 例。ＭＲＩ 检查在ＧＥ Ｖｅｃｔｒａ０ ．５Ｔ 和ＧＥｓｉｇｎａ Ｈｏｒｉｚｏｎ１ ．５Ｔ 超导成像仪上进行，采集矢状面ＦＳＥ Ｔ２ ＷＩ 像，横断面ＳＥ Ｔ１ ＷＩ 像和ＦＳＥ Ｔ２ ＷＩ 像，并对各种病变所致子宫和宫颈的位置、大小、外形与其各层结构变化进行仔细观察和分析，与手术病理对照，以确定ＭＲＩ 的诊断价值。结果：３９例ＦＳＥ Ｔ２ ＷＩ 图像均清晰显示子宫及宫颈诸层结构；矢状面更可清楚显示子宫位置和大小。３９ 例病变均经病理证实，２３ 例为子宫肌瘤，子宫形态均增大，连结层和内膜层可受压，其中１７ 例Ｔ１ ＷＩ 和Ｔ２ ＷＩ 上表现为低信号影，６ 例为低到高不均匀信号影。１２ 例为子宫腺肌瘤，Ｔ２ ＷＩ 上连结层结构不清及较低信号，且增厚。１ 例为纳氏囊肿，Ｔ１ ＷＩ 上为子宫颈后壁内低信号囊状影，边缘光滑，Ｔ２ ＷＩ 上为均匀高信号影。本组有１ 例多发性肌瘤出血ＭＲＩ 上被误诊为子宫腺肌瘤；有２ 例子宫浆膜下肌瘤似游离于盆腔内，而漏诊。结论：ＭＲＩ 横断面及矢状面ＦＳＥ Ｔ２ ＷＩ

Purpose:To evaluate the diagnostic value of MRI examination in the demonstration of benign uterine tumors by analysing their MRI findings. Materials and Methods: 39 female cases suspected clinically of benign uterine tumors were examined on GE Vectra 0.5 T and GE Signa Horizon 1.5 T superconductive MR systems.Axial and sagittal Fast spinecho T2W images as well as SE T1W images were acquired in all cases.The size,location,shape and structure of the uterus and cervix shown in MRI images were carefally analysed and compared with the pathologic findings.Results: In all cases the uterine shapes and structures were demonstrated well on FSE T2W images.The sagital FSE T2W images also depicted the uterine location and size very accurately.In 23 cases proven by pathology had to be leiomyomas,the low signal intensity areas were shown on T1W/T2W images in 17 cases and uneven signal intesity areas mingled with low and high signals were seen in 6 cases.In the above 23 cases,the uterine shape was enlarged and the junction or endometrial layers were continued without interruption.In 12 cases of adenomyosis with diffuse demarcated low signal intensity areas were shown on T2W images.One cases proven to be cervical nabothian cyst with low signal intensity area was shown on T1W images and high signal intensity area seen on T2W images. One multiple leiomyomas with hemorrhage was misdiagnosed by MRI to be adenomyosis,two subserosal leiomyomas were missed by MRI because of the unusual locations.Conclusion:MRI FSE T2W could depict the uterine shape,location and structure clearly and is a very useful modality in the evaluation of uterine tumors.