子宫内膜息肉、Ⅰ期子宫内膜癌不同MR序列信号特征及与病理对照研究

Different Signal Characteristics of MR Sequences of Endometrial Polyps and Endometrial Cancer at Stage I and Comparison and Research with Pathology

目的分析子宫内膜息肉、Ⅰ期子宫内膜癌不同MR序列信号特征,并与病理进行对照研究。方法回顾性分析本院2018年4月至2020年6月收治且经病理确诊的Ⅰ期子宫内膜癌(n=26)、子宫内膜息肉(n=33)患者的临床资料,进行MR检查,对比分析两者MR特征。结果DWI序列上,Ⅰ期子宫内膜癌病变与子宫肌层信号强度差值显著高于子宫内膜息肉(P<0.05)。T_(2)WI序列:Ⅰ期子宫内膜癌高信号小囊、低信号纤维核心较子宫内膜息肉少见(P<0.05)。T_(2)WI、DWI上Ⅰ期子宫内膜癌、子宫内膜息肉均可见周围样高信号,但子宫内膜息肉较Ⅰ期子宫内膜癌多见(P<0.05)。且与子宫内膜息肉比较,Ⅰ期子宫内膜癌出现出血灶、带蒂、窄基底及结节带完整的几率明显下降(P<0.05)。结论MR检查在鉴别诊断子宫内膜息肉、Ⅰ期子宫内膜癌中具有重要价值,两者MR征象各具其特异性,临床可根据子宫内膜特有的形态学特征、病灶组织强化、DWI序列信号特征等辅助信息提高MR诊断准确率。

Objective To analyze the different signal characteristics of MR sequences of endometrial polyps and endometrial cancer at stage I,and compare them with pathology.Methods The clinical data of patients with endometrial cancer at stage I(n=26)and endometrial polyps(n=33)who were admitted to our hospital from April 2018 to June 2020 and were diagnosed by pathology were retrospectively analyzed.The patients were examined by MR,and the MR characteristics of them were compared and analyzed.Results On the DWI sequence,the difference value in signal intensity between endometrial cancer at stage I and myometrium was significantly higher than that between endometrial polyps and myometrium(P<0.05).On the T_(2)WI sequence,follicles with high signal and fiber cores in patients with endometrial cancer at stage I were less common than in patients with endometrial polyps(P<0.05).On T_(2)WI,DWI,stage I endometrial cancer and endometrial polyps all showed peripheral hyperintensity,but endometrial polyps at stage I were more common(P<0.05).And compared with that in endometrial polyps,the probability of lesions with hemorrhage,pedunculation,narrow base,and intact nodular band in endometrial cancer at stage I significantly reduced(P<0.05).Conclusion MR examination is of great value in the differential diagnosis of endometrial polyps and endometrial cancer at stage I.Both their MR signs have their own specificities.In clinic,the accuracy of MR can be improved based on auxiliary information such as the unique morphological characteristics of the endometrium,the enhancement of the lesion tissue,and the characteristics of the DWI sequence signal.