3.0T MRI诊断子宫少见原发恶性肿瘤

3.0T MRI in diagnosis of uterine rare primary malignancies

目的探讨子宫少见原发恶性肿瘤的MRI表现及特征,并与术后病理对照。方法回顾性分析11例子宫少见恶性肿瘤的MRI表现特点。结果 2例子宫内膜癌肉瘤、1例内膜间质肉瘤表现为宫腔内软组织肿块,伴不同程度出血、坏死及囊变;1例小细胞癌表现为宫颈肌层的巨大肿块,信号较均匀;1例横纹肌肉瘤、3例平滑肌肉瘤、3例淋巴瘤起源于子宫肌层,表现为肌层弥漫或局限性肿块,DWI中1例平滑肌肉瘤弥散受限不明显,淋巴瘤弥散受限显著。结论MRI有助于诊断子宫少见原发恶性肿瘤,可准确判断肿瘤部位及其与周围组织的关系,最终确诊需依靠病理检查。

Objective To explore the MRI performance and characteristics of rare uterine primary malignancies and com- pare with pathology. Methods MRI features of 11 patients with uterine primary rare malignancies were retrospectively analyzed. Results MRI showed soft tissue mass in endometrial cavity, with varying degree of hemorrhage, necrosis and cyst- ic degeneration, which enhanced irregularly after injection of contrast agent in 2 with endometrial sarcoma and 1 with endometrial stromal sarcoma. One small cell carcinoma manifested as huge mass with signal equal to cervical muscle. One rhabdomyosarcoma, 3 leiomyosarcomas and 3 lymphomas originating from myometrium present as diffuse or limited masses in uterine muscle, among them 1 leiomyosarcoma showed no obvious restricted diffusion, while the lymphomas showed significantly restricted diffusion in DWI. Conclusion MRI is conducive to diagnose uterine rare primary malignancies, which is able to accurately depict the location of the tumor and the relationship with surrounding tissue, but final diagnosis still relies on pathology.