子宫脂肪平滑肌瘤超声与临床病理表现对照分析

Comparative analysis of ultrasonographic and pathologic findings of uterine lipoleiomyoma

目的探讨子宫脂肪平滑肌瘤的声像图特征。方法回顾性分析经手术病理证实为子宫脂肪平滑肌瘤的21例患者临床及超声检查资料。应用全自动图像分析软件（Image-Pro Plus）估算病理图像中脂肪细胞的含量。并将声像图与病理表现进行对照分析。结果 21例子宫脂肪平滑肌瘤患者共25个肿瘤,病灶位于子宫体肌壁间17个,浆膜下5个,黏膜下2个,宫颈部1个;瘤内呈致密高回声13个,呈高、低相间回声9个,呈低回声3个;瘤内血流信号Adler血流半定量分级为0级8个病灶,Ⅰ级13个病灶,Ⅱ级3个病灶,Ⅲ级1个病灶。瘤内脂肪细胞含量10%~95%;脂肪细胞呈点状、簇状、片状分布,与平滑肌细胞相间排列。结论子宫脂肪平滑肌瘤超声表现具有一定特征,以致密高回声为主。致密高回声提示病理组织中脂肪细胞含量较高。

Objective To explore the ultrasound characteristics of uterine lipoleiomyoma.Methods The clinical and ultrasound data of 21 patients with lipoleiomyoma confirmed by surgical pathology were retrospectively analyzed.The level of adipose cells in pathological images were determined by the automatic image analysis software（Image-Pro Plus）.And the ultrasound features and the pathology performance were comparatively analyzed.Results There were 25 tumors in 21 patients with uterine lipoleiomyoma,included 17 lesions located in uterine corpus,5 lesions in uterine submucosa,2 lesions in uterine subserosa,1 lesion in cervix.The dense high echoes were found in 13 lesions.And the mixed echoes of high and low were found in 9 lesions.The hypoechoes were found in the other 3 lesions.According to Adler＇s semi quantitative method,the tumors blood flows were manifested as grade 0 of 8 lesions,gradeⅠ of 13 lesions,grsde Ⅱ of 3 lesions and grade Ⅲ of 1 lesion.The content of adipose cell was 10%—95% in the tumor.The adipose cells distributed alternately with the smooth muscle cells,in the forms of dot,cluster and sheet.Conclusion The uterine lipoleiomyoma has characteristic ultrasonographic performance of dense hyper echo,which points out that the content of adipose cells is higher in pathological tissue.