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[目的]探讨子宫肉瘤的MRI表现,以提高对该疾病的影像学诊断及鉴别诊断水平。[方法]回顾性分析经手术病理证实的22例子宫肉瘤MRI资料,分析病灶部位、浸润深度、信号特点以及动态增强表现,DWI图信号表现,是否存在出血、坏死或囊变。[结果 ]肿瘤多呈不规则软组织肿块,多数位于宫体(90%),浸润子宫肌层。病灶T1WI呈等或稍高信号,T2WI表现为混杂高信号。所有病例肿瘤实质均可见动脉期明显强化,并呈持续强化特点。出血及坏死、囊变多见。7例(32%)强化幅度达到或超过子宫肌层,15例(68%)可见网格状强化。9例(40%)病例可见明显强化区内条索状低信号影,呈“漩涡征”。DWI呈明显高信号。[结论]子宫肉瘤MRI表现出一定特点,其T2WI信号及动脉增强方式对诊断具有一定意义,结合DWI有助于该疾病的术前诊断。
[Objective] To investigate the MRI findings of uterine sarcoma in order to improve the imaging diagnosis and differential diagnosis of this disease. [Methods] MRI data of 22 cases of uterine sarcoma confirmed by surgery and pathology were retrospectively analyzed. The lesion location, depth of invasion, signal characteristics and dynamic enhancement were analyzed. The signal of DWI showed the presence of hemorrhage, necrosis or cystic degeneration. [Results] Most of the tumors were irregular soft tissue mass, mostly located in the uterus (90%), infiltrating the myometrium. T1WI lesions were equal or slightly higher signal, T2WI showed mixed high signal. All cases of tumor were visible in the arterial phase was significantly enhanced, and continued to strengthen the characteristics. Bleeding and necrosis, cystic degeneration more common. In 7 cases (32%), myometrial enhancement was achieved or exceeded, and in 15 cases (68%), myometrial enhancement was observed. In 9 cases (40%) cases showed obvious enhancement of bar-like low signal in the area, showing “whirlpool sign.” DWI was significantly higher signal. [Conclusion] The MRI of uterine sarcoma shows some characteristics. The T2WI signal and the arterial enhancement mode are of certain significance for the diagnosis. Combined with DWI, it is helpful for the preoperative diagnosis of the disease.