MRI在子宫肌瘤定位和定性诊断中的价值分析

Value of MRI in uterine leiomyoma localization and quality assessment

目的:探讨MRI检查在子宫肌瘤定位和定性诊断中的价值。方法:对30例子宫肌瘤患者的MRI检查资料进行回顾性分析,着重分析不同部位子宫肌瘤在MRI图像中的表现及不同类型子宫肌瘤在多种MRI序列中的特征,并与术后病理进行对照分析。结果:30例患者MRI共检出58个病灶,MRI可清晰显示病灶的大小、分布及位置。肌壁间肌瘤常被肌层包围绕;浆膜下肌瘤位于子宫浆膜下,常伴有挤压肌层的征象;黏膜下肌瘤瘤体直接位于子宫内膜层内。多数子宫肌瘤在T1WI图像中均表现为均匀低或等信号,在T2WI和弥散成像上,普通型肌瘤多呈均匀低信号,细胞型肌瘤呈均匀稍高信号,而退变型肌瘤多呈不均匀混杂信号。增强扫描,普通型肌瘤以均匀强化多见;细胞型肌瘤以显著均匀强化为主;退变型以周边或轻度强化为主。MRI定性诊断与病理诊断间的符合率为93.1%。结论:MRI检查在子宫肌瘤的定位和定性诊断中具有重要价值,可为临床治疗选择提供重要参考依据。

Objective： To evaluate the value of MRI for uterine leiomyoma localization and quality assessment. Methods： MRI and pathology results of 30 cases of uterine leiomyoma were retrospectively analyzed, with emphasis on the MRI display of uterine leiomyoma located at different positions and the MRI characteristics of different types of uterine leiomyoma in various MRI series, and cross-analyzed with the results of surgical pathology. Results： There were 58 lesions in 30 cases. MRI could clearly demonstrate the lesion size, position and distribution. Intramural myoma was surrounded by muscular layer; subserous myoma located in subserosa often with accompanying sign of pressed muscular layer; and submucous myoma located directly in the eudometrium of uterus. Almost all the leiomyomas showed slight hypointensity or isointensity on T1 weighted images. Most of the ordinary leiomyomas displayed hypointensity on T2 weigthed images and diffusion Images, and most cellular leiomyomas manifested as slight hyperintensity, degenerated leiomyomas manifested as uneven mixing signals. In enhancement scanning, ordinary leiomyomas mostly were homogenously enhanced, most cellular leiomyomas showed heavy homogenous enhancement, and degenerated leiomyomas mostly displayed mild enhancement. The diagnosis accordance rate between MRI and pathology diagnosis was 93.1%. Conclusions： MRI has great value for uterine leiomyomas localization and quality assessment, it can provide important reference for selecting clinical treatment.