MRI上测量子宫径线鉴别子宫浆膜下肌瘤与卵巢肿瘤的价值

The value of uterine diameters on MRI in differentiating subserous leiomyomas from ovarian tumors

目的:探讨MRI上测量的子宫径线对子宫浆膜下肌瘤与卵巢肿瘤的鉴别诊断价值。方法:收集2019年6月—2022年4月经手术病理证实的37例子宫浆膜下肌瘤(浆膜下肌瘤组)与42例卵巢肿瘤(卵巢肿瘤组)患者的术前MRI图像,测量子宫长度、子宫厚度、子宫高度、子宫内膜长度、宫底骶岬距离、肿瘤最大径、肿瘤子宫界面长度,并记录肿瘤桥血管征的出现频率。采用独立样本t检验、曼-惠特尼U检验或χ^(2)检验比较两组肿瘤各参数的差异。结果:浆膜下肌瘤组子宫长度、子宫高度、子宫内膜长度和肿瘤子宫界面长度均大于卵巢肿瘤组(t=4.852、4.588、3.975,χ^(2)=-2.761,均P<0.05),而浆膜下肌瘤组宫底骶岬距离小于卵巢肿瘤组(χ^(2)=-4.289,P<0.05)。浆膜下肌瘤组的桥血管征出现率高于卵巢肿瘤组(89.2%vs.19%;P<0.05)。结论:子宫长度、子宫高度、子宫内膜长度和肿瘤子宫界面长度较大,宫底骶岬距离较小,且出现桥血管征时,提示子宫浆膜下肌瘤的诊断。

Objective:To explore the value of uterine diameters measured on MRI in differentiating subserous leiomyomas from ovarian tumors.Methods:The preoperative MRI of 37 patients with uterine subserous leiomyomas(subserous leiomyomas group)and 42 ovarian tumors(ovarian tumors group)confirmed by surgery and pathology were collected from June 2019 to April 2022.The length of uterus,thickness of uterus,height of uterus,length of endometrium,distance between uterine fundus and sacral promontory,maximum diameter of tumor,length of tumor and uterine interface were measured.The frequency of bridging vascular sign was recorded.Independent sample t-test,Mann-Whitney U test orχ^(2)test was used to compare the differences of uterine extension between the two groups.Results:The length of uterus,height of uterus,length of endometrium,and length of tumor and uterine interface of subserous leiomyomas group were larger than those of ovarian tumors group(t=4.852,4.588,3.975,χ^(2)=-2.761,all P<0.05).The distance between uterine fundus and sacral promontory of subserous leiomyomas group was lower than that of ovarian tumors group(χ^(2)=-4.289,P<0.05).The frequency of bridging vascular sign in subserous leiomyomas group was higher than that in ovarian tumors group(89.2%vs.19%,P<0.05).Conclusion:When the length of uterus,height of uterus,length of endometrium and length of tumor and uterine interface are large,the distance between fundus and sacral promontory is small and the bridge sign is positive,the diagnosis of subserous leiomyomas is suggested.