子宫内膜癌的MRI诊断价值

Diagnotic value of endometrial carcinoma with MRI

目的 探讨MRI对子宫内膜癌的诊断价值。方法 共收集本院1994—1998年13例女性病例和正常女性盆腔,MRI栓查作对照分析。MRI检查采集矢状面FSE T2WI像,横断面SE T1WI像和FSE T2WI像,并行Cd—DTPA增强T1WI。结果 MRI横断面及矢状面FSE T2WI清晰显示子宫位置、结构和大小,而SE T1WI区分子宫及宫颈诸层结构差。9例临床及MRI疑诊子宫内膜癌者,8例经手术病理证实为子宫内膜癌。MRIT2WI均表现为宫腔内膜层不规则高信号影,分别向连结层肌层和浆膜层侵犯;另1例病理证实为子宫平滑肌肉瘤,T2WI图像上与内膜癌表现相像,高信号影侵犯肌层,部分浆膜层受侵。结论 MRI横断面及矢状面FSE T2WI像能清晰显示子宫各层正常结构,对子宫内膜癌的定性和分期具较大优势。

Purpose To evaluate the value of MRI in the diagnosis of endometrial carcinoma. Methods 13 females including 9 cases clinically suspected of endometrial carcinoma and 4 normal cases as control group were performed with MRI examination during 1994 - 1998. Axial SE T1WI with or without Gd - DTPA, axial and sagittal FSE T2W1 were acquired in all thirteen cases. Results On axial and sagittal FSE T2WI the sliape and structure of uterus could be distinguished clearly while it could not be shown well on axial SE T1WI with or without Gd - DTPA. In 9 cases suspected of endometrial carcinoma by MRI and clinical examination eight were proven to have the endometrial carcinoma by operation and pathologi-al findings. The FSE T2WI images demonstrated the signs of high signal of the neoplasms invading the endometrial cavity the junctional and myome-tial tissues of uterus according to their stages. In the one case proven to be leiomyosarcomas the MRI findings similar to endometrial carcinoma was observed on FSE T2WI except that the surface of the uterus was invaded also. Conclusion MRI axial and sagittal FSE T2WI images could demon-slrate the shape snd structute of the uterus very well and have certain advantages in diagnosing and staging of the endometrial carcinoma.