子宫腺肉瘤的MRI影像特征分析

MRI Features of Uterine Adenosarcoma

目的探讨子宫腺肉瘤的MRI影像特征,加深认知并提高其影像学诊断的能力。方法回顾性分析首都医科大学附属北京妇产医院2016年1月至2019年12月经病理证实的6例子宫腺肉瘤患者的MRI影像表现。结果6例腺肉瘤中有5例位于宫腔,1例位于宫颈;3例瘤体内可见多发微小长T1长T2囊泡影,2例瘤体内可见流空血管影。瘤体强化曲线均为Ⅱ型曲线,强化比值(病变/肌层)位于0.45~0.90之间,其中瘤体强化程度随瘤体最大径增加而增加。ADC值位于(0.565~0.900)×10^(-3) mm^(2)·s^(-1)之间,中位数ADC值为0.854×10^(-3) mm^(2)·s^(-1)。结论子宫腺肉瘤MRI影像具有一定特征,典型特征表现为肿块型,边界清晰锐利,瘤内不均质,瘤内多见多发微小囊泡影,瘤内血供丰富,甚至可见流空血管影,DWI信号较高,ADC值较低。

Objective To explore the MRI features of uterine adenosarcoma for deepening the cognition and improving the ability of imaging diagnosis.Methods MRI findings of 6 patients with uterine adenosarcoma confirmed by pathology in Beijing Obstetrics and Gynecology Hospital from January 2016 to December 2019 were retrospectively analyzed.Results Among the 6 patients,adenosarcoma occured in the uterine cavity in 5,and in the cervix in 1.Long T1 and T2 signals of multiple microcysts were observed in 3 cases,and flow void in 2 cases.The enhanced curve was typeⅡcurve,and the enhancement ratio(lesion/muscular layer)ranged from 0.45 to 0.90.The enhancement of tumor increased with the diameter.The ADC value ranged from 0.565×10^(-3) to 0.900×10^(-3) mm^(2)·s^(-1),with a median value of 0.854×10^(-3) mm^(2)·s^(-1).Conclusion The typical MRI features of uterine adenosarcoma include large mass,clear and sharp boundary,heterogeneity,multiple microcysts,abundant blood supply,flow void,high signal intensity on DWI,and lower ADC value.