子宫肌瘤子宫动脉栓塞术前后的MRI表现

MRI of uterine fibroleiomyoma before and after embolization of uterine arteries

目的 探讨子宫肌瘤子宫动脉栓塞术 (UAE)前后的MRI表现。方法 对 34例子宫肌瘤患者 (共 6 2个肌瘤 )在UAE前和术后 4个月行MR平扫和增强检查 ,肌瘤信号强弱与骨骼肌相比较 ,肌瘤体积测量按椭球计算公式。结果 6 2个肌瘤术前平均体积为 85 6cm3 (范围 0 3～2 4 8 4cm3 ) ;UAE后 4个月肌瘤平均体积为 32 6cm3 (范围 0 3～ 6 5 4cm3 ) ,体积总缩小率为 5 8 32 % (t=3 18,P <0 0 1) ,术前体积大于 35cm3 的 4 0个肌瘤缩小率为 6 2 4 8% (t=4 4 5 ,P <0 0 1) ;而术前体积小于 35cm3 的 2 2个肌瘤体积缩小率为 38 6 9% (t=1 13,P >0 0 5 )。UAE后T1WI上肌瘤信号 38个为均匀等、低信号 ,2 0个呈等信号 ,4个为稍高信号 ;T2 WI上肌瘤信号 5 5个为极低信号 ,7个为稍低信号。UAE后 4 0个较大肌瘤中 38个无强化 ,而 2 2个术前体积小于 35cm3 的肌瘤仅 5个无强化 ,17个仍有不同程度强化 ,正常子宫肌层强化明显。结论 MRI有助于评价子宫肌瘤UAE前后的体积和血供改变。

Objective To evaluate the MRI appearances of uterine fibroleiomyomas before and after uterine arterial embolization (UAE).Methods MRI was performed in 34 patients(62 fibroleiomyomas)before and 4 months after embolization of the uterine arteries.The signal intensity and gadolinium enhancement characteristics of fibroleiomyomas were assessed in comparison with those of skeletal muscle.The volume of the lesion was measured by using the ellipsoid formula.Results The mean lesions volume was 85.6cm3 (0.3-248.4 cm3) before embolization and 32.6 cm3 (0.3-65.4 cm3) after UAE.The mean reduction in lesions volume was 58.32% at 4 months.The reduction in 40 lesions whose volume was over 35 cm3 before UAE was 62.48%,while the reduction in 22 lesions whose volume was less than 35 cm3 before UAE was 38.69%.Before UAE,all fibroleiomyomas presented as intermediate or low signal intensity on T 1WI,low or heterogeneous signal intensity on T 2WI.After UAE,38 lesions showed homogeneous low signal, 20 showed iso-signal and 4 showed slightly high signal on T 1WI while all cases were extremely low signal on T 2WI except 7 were slightly low.On dynamic and delayed contrast enhanced images,40 lesions whose volume was over 35 cm3 before UAE remained no enhancement except 2,but 22 lesions whose volume was less than 35 cm3 before UAE enhanced heterogeneously with a different degree except 5.The normal myometrium after UAE enhanced obviously just as that before treatment.Conclusion MRI was useful for the evaluation of the volume changes and the blood supply in fibroleiomyomas before and after UAE.