侵蚀性葡萄胎的MRI影像特点及分析

Invasive Mole MRI Imaging Features and Analysis

目的探讨侵蚀性葡萄胎的MR信号特点、形成原因及MRI检查的临床价值。方法回顾性分析11例侵蚀性葡萄胎患者的临床及影像资料,所有病例经临床最终确诊。结果 11例均表现为子宫不同程度增大,病灶主体均位于子宫肌层,11例可见肌层内迂曲扩张血管,6例伴宫旁迂曲血管。病灶信号不均匀,表现为T1WI等低信号、T2WI等高信号,7例可见小片状T1WI高信号,提示出血。6例附件区见囊性灶,增强后病灶实性部分可见明显早期、持续强化,实性部分扩散加权成像(DWI)表现为等或稍高信号。结论侵蚀性葡萄胎的MRI表现具有特征性,MR检查可以较好显示病变的内部结构、观察病变累及范围,结合临床病史及实验室检查,可以提高诊断信心,为临床制定治疗方案及疗效观察提供依据。

Objective To investigate the MR signal characteristics,formation causes and clinical value of MRI in invasive hydatidiform mole.Methods The clinical and imaging data of 11 patients with aggressive hydatidiform mole were retrospectively analyzed.All cases were confirmed by clinical diagnosis.Results All of the 11 cases showed an increase in the size of uterus.The main body of the lesion was located in the myometrium.In 11 cases,the vascular shadow was distorted in the muscular layer,and 6 cases were accompanied by parametrial tortuous vessels.The lesion signal was not uniform,showing low signal such as T1WI and T2WI high signal,and 7 cases showed small T1WI high signal,indicating bleeding.In 6 cases,the cystic foci were seen in the attachment area.After the enhancement,the solid part of the lesion showed obvious early and continuous enhancement,and the solid part of the DWI showed equal or slightly higher signal.Conclusion The MRI findings of erosive hydatidiform moles are characteristic.MR examination can better display the internal structure of the lesions and observe the extent of lesions.Combined with clinical history and laboratory examination,it can improve the confidence of diagnosis and provide clinical treatment and therapeutic observation accordingly.