子宫内膜息肉、Ⅰ期子宫内膜癌的MRI表现与病理分析

MRI Findings and Pathological Analysis of Endometrial Polyps and Stage Ⅰ Endometrial Cancer

目的探讨子宫内膜息肉、Ⅰa期子宫内膜癌的磁共振成像(MRI)表现与病理特点。方法回顾性分析经手术病理证实为Ⅰa期子宫内膜癌患者57例(癌变组)和子宫内膜息肉患者32例(息肉组)的资料,采用MR平扫、扩散加权成像(DWI)及增加动态增强(DCE)扫描,分析对比两组MR平扫、DWI与DCE表现和表观扩散系数值(ADC)伪彩图与ADC值。结果息肉组肿块最大径在11~46(22.36±5.57)mm,在T1WI呈等信号,在T2WI呈稍低信号或中等信号,在DWI呈现低信号或稍高信号,ADC伪彩图大体呈绿色表现,增强扫描强化特点为持续渐进性强化;癌变组肿块最大径在18~48(25.16±5.57)mm,在T2WI呈等信号或稍高信号,在DWI呈高信号,ADC伪彩图大体呈蓝色表现,强化特点为快进慢出型。息肉组经MR平扫为肿块内纤维核、囊变、出血、带蒂、窄基底及结合带完整的出现率显著高于癌变组(P<0.05);息肉组ADC值显著高于癌变组,差异均有统计学意义(P<0.05)。结论MRI应用于子宫内膜息肉、Ⅰa期子宫内膜癌的鉴别中价值显著。

Objective To explore the magnetic resonance imaging(MRI)findings and pathological features of endometrial polyps and stage Ⅰa endometrial cancer.Methods The data of 57 patients with stage Ⅰa endometrial cancer(cancerous group)and 32 patients with endometrial polyps(polyp group)confirmed by surgery and pathology were retrospectively analyzed.The patients were given MR plain scan,diffusion-weighted imaging(DWI)and dynamic contrast enhancement(DCE)scan,and the findings of MR plain scan,DWI and DCE and apparent diffusion coefficient(ADC)pseudo-color map and ADC value were analyzed and compared between the two groups.Results The maximum diameter of mass was 11-46(22.36±5.57)mm in polyp group with equal signal on T1WI,slightly low signal or medium signal on T2WI and low signal or slightly high signal on DWI,and the pseudo-color map of ADC was generally green,and the enhanced scanning enhancement was characterized by continuous progressive enhancement.The maximum diameter was 18-48(25.16±5.57)mm in cancerous group with equal or slightly high signal on T2WI and high signal on DWI,and the pseudo-color map of ADC was generally blue,and the enhancement was characterized by fast in and slow-out.The incidence rates of inosine,cystic change,hemorrhage,pedicle skin flap,narrow base and complete combined band of the mass in polyp group were significantly higher than those in cancerous group(P<0.05).The ADC value in polyp group was significantly higher than that in cancerous group(P<0.05).Conclusion MRI has significant value in the identification of endometrial polyps and stage Ⅰa endometrial cancer.