子宫肌瘤MRI信号与病理组织特点的对照研究

Control research of uterine fibroids between magnetic resonance imaging signal and pathological tissue features

目的 探讨子宫肌瘤的MRI信号与病理组织特点之间的相关性。方法 回顾性分析2011年3月至2012年3月山东省日照市人民医院临床诊断为子宫肌瘤行子宫全切或肌瘤剥离的患者60例。所有患者均于术前1~3 d行盆腔MRI扫描,共确诊97个肌瘤。按肌瘤的MRI信号特点分组,并与术后病理结果对照。结果 97个肌瘤中,63个肌瘤术前MRI诊断为未变性肌瘤,病理结果证实49个（77.8%,49/63）为未变性肌瘤,10个（15.9%,10/63）为透明样变肌瘤,4个为富于细胞性肌瘤;21个肌瘤术前MRI诊断为富于细胞性肌瘤,病理结果证实13个（62.0%,13/21）为富于细胞性肌瘤,4个（19.0%,4/21）为未变性肌瘤,4个（19.0%,4/21）为透明样变性肌瘤;8个肌瘤术前MRI诊断为黏液样变性肌瘤,病理结果证实7个为黏液样变性肌瘤,1个为富于细胞性肌瘤;3个肌瘤术前MRI诊断为囊性变肌瘤,病理结果证实2个为囊性变肌瘤,1个为黏液样变性肌瘤;2个肌瘤术前MRI诊断为红色变肌瘤,病理结果得以证实。经线性相关分析,子宫肌瘤术前MRI诊断结果与病理结果呈明显相关（R=0.90）。结论 子宫肌瘤的MRI信号与病理组织特点有良好的相关性,可由MRI信号特点判断病理组织类型。。

Objective To explore the correlation between magnetic resonance imaging （MRI） signal and pathologic features of uterine fibroids. Methods Sixty cases with uterine fibroids in Rizhao People＇s Hospital of Shandong Province from March 2011 to March 2012 were selected retrospectively. All the patients were performed hysterectomy or myoma dissection 1-3 clays after MRI examination, and 97 fibroids were found. Groups were set according to the MRI signal characteristics, and the results were compared with postoperative pathology. Results In the 63 uterine fibroids which were considered as ordinary no degeneration fibroids by MRI examination before operation, 49 of them （77.8%） were no degeneration fibroids, 10 of them （15. 9% ） were hyaline degeneration fibroids, 4 of them were rich cell fibroids, conformed by pathological method. In the 21 uterine fibroids which were considered as rich cell fibroids by MRI, 13 of them （62.0%） were correct results, 4 （19.0%） were ordinary no degeneration fibroids, 4 （ 19.0% ） were hyaline degeneration fibroids, 2 were myxoid degeneration fibroids. In the 8 uterine fibroids which were considered as myxoid degeneration fibroids by MR1, 7 of them were correct results, 1 was rich cell fibroid. In the 3 uterine fibroids which were considered as cystic degeneration fibroids by MRI, 2 of them were correct results, 1 was myxoid degeneration fibroids. Two were diagnosed as red degeneration fibroid by MRI, and the results were correct. The linear correlation analysis showed that MRI diagnosis was significantly related to the pathological finding （ R = 0. 90 ）. Conclusions The MRI signal has a close correlation with pathologic features of uterine fibroids. The pathological type of fibroids can be judged through MRI signal characteristics.