摘要
目的:探讨妊娠滋养细胞疾病(GTD)的MRI表现及与病理改变的相关性,旨在提高对本病的认识。方法:回顾性分析21例妊娠滋养细胞疾病患者的MRI表现、病理资料、手术所见及临床资料。结果:21例中葡萄胎9例,主要MRI表现为子宫体积增大,宫腔内有葡萄状或蜂窝状囊泡影,病变包膜完整;其中8例行增强扫描,显示囊泡无明显强化,7例囊泡间分隔较均匀强化,1例分隔强化欠均匀。侵袭性葡萄胎及绒毛膜癌各6例,MRI检查示宫体扩大,腔内蜂窝状或囊实性异常信号影,分隔杂乱;包膜不完整,侵犯肌层;3例合并病变内出血;12例宫腔内或肌层内血管增粗、增多;11例子宫周围血管增多、纡曲;其中5例行增强扫描,显示肿瘤内分隔及实性部分强化,囊性部分无明显强化,2例病变内有片状强化。结论:妊娠滋养细胞疾病的MRI表现具有一定特征性,MRI能较好地显示病变的内部结构、明确肿瘤范围,结合临床病史及实验室检查可以作出诊断,并可在早期提示病变的良恶性,从而指导临床制订治疗方案。
Objective：To explore the correlation between the manifestations of MRI and pathology,and to improve the knowledge of gestational trophoblastic diseases（GTD）.Methods：The MRI manifestations,pathology,operational records and clinical data were analyzed retrospectively in 21 cases with gestational trophoblastic disease.Among the 21 cases of gestational trophoblastic disease,9 cases were hydatidiform mole,6 cases invasive hydatidiform mole and 6 cases choriocarcinoma.Results：In the 9 cases of hydatidiform mole,MRI showed increased uterine volume and honeycomb-like or grape-like vesicles in the cavity of uterus with complete tumor capsule.Enhanced scanning of 8 cases showed homogeneous enhancement of septations in 7 cases and heterogeneous enhancement in 1 case.In 6 cases of invasive hydatidiform mole and 6 cases of choriocarcinoma.MRI showed enlargement of 11 uterus with honeycomb-like or cystic-solid signal intensity with disordered septations,incomplete capule and invasion of myometrium;3 cases showed internal bleeding;12 cases showed dilatation and tortuosity of the vessles in cavity and myometriumof uterus;11 cases showed dilatation and tortuosity of the vessles around uterus.Enhanced scanning of 5 cases showed septal enhancement and enhancement of the solid part,2 cases showed intra-mass enhancement just like ＂blood lake＂.Conclusion：GTD had characteristic MRI manifestations which showed the structures and extent of the lesions very well.MRI can also suggest the benign ro malignant nature of the lesions,combined with clinical history and laboratory examination,diagnosis of GTD can be made.
出处
《放射学实践》
2012年第3期333-336,共4页
Radiologic Practice
关键词
妊娠滋养细胞疾病
妊娠滋养细胞肿瘤
磁共振成像
子宫病变
Gestational trophoblastic disease
Gestational trophoblastic tumor
Magnetic resonance imaging
Uterine diseases
