摘要
目的探讨MRI扩散加权成像(DWI)表观扩散系数(ADC)值在子宫肉瘤诊断中的应用价值。方法回顾性分析24例(包括3例平滑肌肉瘤、5例子宫内膜间质肉瘤、4例腺肉瘤、12例癌肉瘤)经手术病理证实的子宫肉瘤DWI及MRI表现,判断肿瘤的位置、大小、信号特点、强化方式、浸润深度、远处转移及分期情况,测量肿瘤实质部分及相应正常子宫肌层、内膜的ADC值。结果肿瘤多表现为信号不均伴肌层浸润的软组织肿块,T1WI呈等或稍低信号,T2WI为中等或高信号,增强多呈明显强化,DWI呈高信号,ADC值减低,本组子宫肉瘤ADC值0.87×10-3mm2/s,显著低于正常子宫肌层(1.59×10-3mm2/s)、内膜(1.73×10-3mm2/s),也显著低于文献报道良性病变的ADC值(1.44～1.55×10-3mm2/s)。结论 ADC值在子宫肉瘤的诊断与鉴别诊断中具有重要价值,结合MRI平扫及动态增强扫描能进一步提高对该病的诊断及术前分期中的准确性。
Objective To investigate the clinical value of apparent diffusion coefficient （ADC） in diagnosis of uterine sarcomas. Methods The MRI and DWI features of 24 patients （3 cases of leiomyosarcoma,5 cases of endometrial stromal sarcomas ,4 cases of adenosarcoma, 12 cases of carcinosarcoma）with uterine sarcomas confirmed by pathologically and surgi- cally were retrospectively analyzed. Tumor location, size, signal feature, invasive extent, enhancement pattern, distant metas- tases,staging of uterine sarcomas were analyzed. The ADC values in the solid area of tumors, the corresponding region of normal myometrium and endometrium were measured in the DW images. Results Uterine sarcoma was often presented as a large infiltrating myometrial mass with heterogeneous hypointensity on Tl weighted image and intermediate to high signal intensity on T2 weighted images. All uterine sarcoma showed higher intensity on DW images and marked enhancement of solid components. The ADC value of uterine sarcomas was0. 87 × 10^-3mm2/s, which was significantly lower than that in the normal myometrium（ 1.59× 10 -3mm2/s） ,endometrium（ 1.73 × 10 -3 mm2/s） and benign lesion （ 1.44 - 1.55 × 10 -3 mm2/s）. Conclusion ADC values have important role in the differential diagnosis of uterine sarcomas. The combination of plain MRI and dynamic contrast enhanced MRI can improve diagnostic accuracy of preoperative staging for uterine sarco-
出处
《临床放射学杂志》
CSCD
北大核心
2013年第3期372-375,共4页
Journal of Clinical Radiology
关键词
磁共振成像
扩散加权成像
子宫肉瘤
Magnetic resonance imaging Diffusion weighted imaging Uterine sarcomas
