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中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (01) : 70 -74. doi: 10.3877/cma.j.issn.1673-5250.2013.01.016

所属专题： 文献；

论著

磁共振成像对巨大子宫肌瘤的诊断价值
杨世喜1,*,*()   
  1. 1. 233000　安徽蚌埠，东南大学医学院附属蚌埠第一医院影像中心
  • 收稿日期:2012-11-09 修回日期:2013-01-01 出版日期:2013-02-01
  • 通信作者: 杨世喜

Diagnostic Value of Magnetic Resonance Imaging of a Huge Uterine Fibroids

Shi-xi YANG1()   

  1. 1. Department of Radiology, Bengbu First Hospital, Medical College of Southeast University, Bengbu 233000, Anhui Province, China
  • Received:2012-11-09 Revised:2013-01-01 Published:2013-02-01
  • Corresponding author: Shi-xi YANG
  • About author:
    Corresponding author: YANG Shi-xi, Email:
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杨世喜. 磁共振成像对巨大子宫肌瘤的诊断价值[J]. 中华妇幼临床医学杂志(电子版), 2013, 09(01): 70-74.

Shi-xi YANG. Diagnostic Value of Magnetic Resonance Imaging of a Huge Uterine Fibroids[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2013, 09(01): 70-74.

目的

探讨巨大子宫肌瘤的MRI表现，提高MRI的诊断水平。

方法

采用回顾性分析法对2011年6月至2012年3月于本院经组织病理学活检确诊为巨大子宫肌瘤的21例患者的MRI矢状位、冠状位、轴位，T1WI，T2WI，STIR序列扫描的数据进行研究，分析巨大子宫肌瘤的MRI表现，并与组织病理学活检结果进行对照研究。

结果

21例患者中，17例巨大子宫肌瘤的最大直径为(13～26)cm，4例直径超过30 cm。手术证实其发生于浆膜下为13例，肌壁间型为6例，黏膜下型为2例。21例巨大子宫肌瘤的T1WI均为等低信号，T2WI和STIR序列上病灶内可见斑片状高信号，其中3例术后组织病理学活检结果证实有钙化。

结论

MRI可以清晰显示巨大子宫肌瘤的位置、大小及其与周围组织的关系，并可判断病灶内部病变，对指导临床治疗具有重要价值。

关键词: 子宫肌瘤, 磁共振成像, 脂肪抑制序列
Objective

Explore magnetic resonance imaging (MRI) manifestations of huge uterine myoma, and to improve the diagnostic level of MRI.

Methods

From June 2011 to March 2012, a total of 21 cases of agittal, coronal, axial, T1WI, T2WI, STIR sequence scanning data by MRI from 21 cases of giant hysteromyoma patients were selected. Their giant hysteromyomas were diagnosis by pathological biopsy in operation, and controlled study by retrospective analysis method on MRI manifestations of huge uterine fibroids, and pathological biopsy results of all patients. The procedure of this study was consistent with ethical standard established by the committee of investigation in human beings of Bengbu First Hospital, Medical College of Southeast University.

Results

In 21 patients, maximum diameters of giant hysteromyoma among 17 cases were (13-26) cm, another diameters among 4 cases were more than 30 cm by MRI. During operation, confirmed for 13 cases in a serous, intramural for 6 cases, 2 cases for submucosal type. For all of giant hysteromyoma had T1WI low signals, T2WI visible lesion spotted on flake and STIR sequence high signal, 3 cases of postoperative pathological biopsy result confirmed that calcification.

Conclusions

MRI can clearly display the location of the fibroids, size and its relationship to surrounding tissues and lesion of judgment internal lesions, and great value for guiding treatment.

Key words: uterus myoma, magnetic resonance imaging, fat suppression sequence
图1 子宫前方巨大子宫肿瘤(21 cm×12 cm×9 cm)的MRI表现：与宫腔相连，膀胱及其他腹腔脏器受压移位(图1a，1b：矢状位T2WI；图1c：T2WI轴位像(女性，46岁)
Figure 1 MRI manifestation of giant hysteromyoma in front of uterine (21 cm×12 cm×9 cm): Mass is attached to the uterine cavity, bladder and other abdominal viscera by pressing SHIFT (Figure 1a，1b: Sagittal T2WI; 1c：T2WI axial images) (Female, 46 years old)
图2 巨大子宫阔韧带平滑肌瘤的MRI表现：内可见信号欠均匀，条片状高信号及膀胱和腹腔脏器受压变形移位(图2a：矢状位T2WI；图2b：矢状位STIR序列；图2c：轴位T2WI像)(女性，49岁)
Figure 2 MRI manifestations of huge uterine broad ligament leiomyoma: Visible signals due to the uniform, flake and bladder and abdominal viscera compressive deformation of high signal shift (Figure 2a: Sagittal T2WI; Figure 2b: Sagittal STIR sequence; figure 2c: Axial T2WI) (Female, 49 years old)
图3 巨大子宫肌瘤的MRI表现：边界清晰，信号欠均匀，其中可见斑点状长T2短T2信号，T1WI呈低信号(图3a，3b，3c：分别为矢状位T2WI ，T1WI及STIR)(女性，57岁)
Figure 3 MRI manifestations of giant hysteromyoma: Borders clear signals due to the uniform, of which visible spots long T2 short T2 signal, T1WI low signal (Figure 3a，3b，3c: Sagittal T2WI，T1WI, STIR, respectively) (Female, 57 years old)
图4 巨大子宫肌瘤的MRI表现：其内可见多发斑点片状高信号，肿瘤壁较厚(图4a，4b，4c：分别为矢状位T2WI，STIR，T1WI。T1WI呈等低信号。彩色多普勒超声显示巨大子宫肌瘤内钙化)(女性，49岁)
Figure 4 MRI manifestations of giant hysteromyoma: Multiple visible spots of high signal tumor with a thick－walled (Figure 4a，4b，4c: Sagittal T2WI，STIR，T1WI, respectively. T1WI shows low signal. Color Doppler flow Imaging displays significant calcification within uterine myoma) (Female, 49 years old)
图5 巨大子宫肌瘤的MRI表现：肿块与宫腔相连，STIR序列上可见肿块内有斑点片高信号(图5a，5b，5c：分别为矢状位T2WI，STIR及T1WI。T1WI呈等低信号)(女性，43岁)
Figure 5 MRI manifestations of giant hysteromyoma: Mass is attached to the uterine cavity, speckled high masses visible on STIR sequence signals (Figure 5a，5b，5c: Sagittal T2WI，STIR and T1WI, respectively. T1WI shows low signal) (Female, 43 years old)
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