摘要
目的:探讨Peutz-Jeghers综合征(PJS)女性患者伴发宫颈胃型腺癌(G-EAC)的临床及影像学特点,以提高PJS的早期诊断水平。方法:选取2021年6月至2024年12月空军特色医学中心收治的12例经病理证实为PJS伴G-EAC患者临床影像学资料,术前12例患者均接受CT检查,有6例患者同时接受MRI检查;分析所有患者临床表现特点以及CT和MR影像学特征。结果:12例G-EAC患者中,无任何异常妇产科相关临床症状7例(占58.3%),有阴道排液增多和(或)阴道出血5例(占41.7%)。影像学检查显示,12例均伴囊肿成分,其中大囊肿5例(占41.7%),微小囊肿与大囊肿并存6例(占50.0%),实性肿块合并少量微小囊肿1例(占8.3%);4例合并少量宫腔积液(占33.3%)。MR表现为多发类圆形长T1、长T2信号,弥散加权成像(DWI)序列弥散无或轻度受限,表观弥散系数(ADC)呈稍高信号;肿瘤以实性成分为主时呈略长T2信号,弥散受限,ADC呈低信号。CT均表现为宫颈增大,局部呈混杂密度囊实性结节、肿块影,部分病灶呈“蜂窝”状改变。增强扫描病灶囊性区域无明显强化,实性区域则呈不均匀强化。术前CT、MR诊断准确率为50.0%。结论:PJS女性患者伴发G-EAC临床表现及CT、MR检查的影像学特征分别为部分患者阴道排液和(或)出血、肿瘤好发于整个宫颈(包括上部)、常合并囊肿样改变以及多呈浸润性生长。PJS临床及CT、MR检查有助于宫颈胃型腺癌的早期诊断。
Objective:To explore the clinical and imaging features of the concomitant gastric-type endocervical adenocarcinoma(G-EAC)in female patients with Peutz-Jeghers syndrome(PJS),so as to improve the early diagnostic level for PJS.Methods:A retrospective analysis was performed on the clinical and imaging data of 12 patients who were confirmed as PJS with G–EAC at Air Force Medical Center,PLA from June 2021 to December 2024.The 12 patients all received computed tomography(CT)examination before surgery,and 6 cases among of them received magnetic resonance imaging(MRI)examination at the same time.The features of clinical performance,and imaging features of CT and MR in all patients were analyzed.Results:In 12 G-EAC patients,7 cases(58.3%)did not occurred any abnormally relative symptoms of gynaecology and obstetrics,while 5 cases(41.7%)occurred increase of vaginal drainage and/or vaginal bleeding.The results of imaging examination indicated that 12 cases occurred concomitant cyst,including 5 cases(41.7%)with large cysts,6 cases(50.0%)that micro cysts coexisted with large cysts,1 case(8.3%)that solid mass combined with small amount of micro cysts,and 4 cases(33.3%)that combined with small amount of uterine cavity effusion.MR performance was the most of occurrences were quasi-circular object with long T1/T2 signals,and the sequences of diffusion weighted imaging(DWI)appeared there was no diffusion or mild restriction,and apparent diffusion coefficient(ADC)appeared slightly high signal.The tumors that mainly were solid components appeared longer T2 signals,which diffusion was limited,and which ADC values appeared low signals.CT images of them presented enlarged cervixes,and mixed-density cystic and solid nodules and mass shadows at local tissues,and cellular change at local lesions.There was not significant strengthen at the cystic fields of the lesion with enhanced scan,and the solid fields appeared uneven enhancement.The accuracy rates both of preoperative CT and MR diagnosis were 50.0%.Conclusion:The clinical appearance,and imaging futures of CT and MR examinations of PJS female patients with G-EAC are respectively:partial patients occur vaginal drainage and/or vaginal bleeding,the most of tumors often occurs at the entire cervix(includes upper segment),often combines with cystic changes,and often appears infiltrating growth.The clinical PJS appearance,CT and MR examinations contribute to early diagnosis for G-EAC.
作者
孟利民
李白容
郑吉春
贾静辉
李相生
王东
Meng Limin;Li Bairong;Zheng Jichun;Jia Jinghui;Li Xiangsheng;Wang Dong(Department of Medical Imaging,Air Force Medical Center,PLA,Air Force Medical University,Beijing 100142,China;Department of Gastroenterology,Air Force Medical Center,PLA,Air Force Medical University,Beijing 100142,China;Pathology Department,Air Force Medical Center,PLA,Air Force Medical University,Beijing 100142,China;Department of Gynaecology and Obstetrics,Air Force Medical Center,PLA,Air Force Medical University,Beijing 100142,China)
出处
《中国医学装备》
2025年第7期45-49,共5页
China Medical Equipment
