【摘要】：目的探討磁共振彌散加權(quán)成像(DWI-MRI)對(duì)子宮肉瘤的診斷價(jià)值,并同組織病理學(xué)進(jìn)行對(duì)照。方法回顧性分析復(fù)旦大學(xué)附屬婦產(chǎn)科醫(yī)院2010年1月至2012年12月間,22例經(jīng)組織病理學(xué)證實(shí)的子宮肉瘤病例。所有病例均前瞻性行MRI和DWI-MRI檢查。將子宮肌瘤和子宮腺肌癥作為對(duì)照組,比較不同組別間表觀彌散系數(shù)值(apparent diffusion coefficient values,ADCs)的差異性。結(jié)果本組資料包括7例平滑肌肉瘤,3例子宮內(nèi)膜間質(zhì)肉瘤,6例腺肉瘤和6例癌肉瘤。大多數(shù)子宮肉瘤(14/20,70%)在DWI-MRI上表現(xiàn)為均質(zhì)高信號(hào)。子宮肉瘤平均ADC值為[(1.05±0.30)×10-3·mm-2·s-1],低于子宮肌瘤[(1.34±0.42)×10-3·mm-2·s-1]和腺肌瘤[(1.12±0.14)×10-3·mm-2·s-1],其中子宮肉瘤和平滑肌瘤間ADC值差別具有顯著統(tǒng)計(jì)學(xué)意義(P=0.019)。在不同亞型子宮肉瘤中,ADC值存在重疊,平滑肌肉瘤和平滑肌瘤間存在顯著統(tǒng)計(jì)學(xué)意義(P=0.018)。結(jié)論DWI-MRI可在常規(guī)MRI基礎(chǔ)上對(duì)子宮肉瘤的診斷提供必要的附加信息,通過(guò)ADC值定量分析有助于鑒別子宮肉瘤和子宮肌瘤,但子宮肉瘤不同亞型間ADC值不具顯著性差異。
[Abstract]:Objective to evaluate the diagnostic value of diffusion-weighted magnetic resonance imaging (DWI-MRI) in uterine sarcoma and to compare it with histopathology. Methods 22 cases of uterine sarcoma confirmed by histopathology were analyzed retrospectively from January 2010 to December 2012 in the affiliated Obstetrics and Gynecology Hospital of Fudan University. MRI and DWI-MRI were performed prospectively in all cases. Uterine leiomyoma and uterine adenomyosis were used as control group to compare the difference of apparent diffusion coefficient (apparent diffusion coefficient value ADCs) between different groups. Results the data included 7 cases of leiomyosarcoma, 3 cases of endometrial stromal sarcoma, 6 cases of adenosarcoma and 6 cases of carcinosarcoma. Most uterine sarcomas (14 / 2070%) showed homogeneous hyperintensity on DWI-MRI. The average ADC value of uterine sarcoma [(1.05 鹵0.30) 脳 10-3 mm-2 s-1] was lower than that of uterine leiomyoma [(1.34 鹵0.42) 脳 10-3 mm-2 s-1] and adenomyoma [(1.12 鹵0.14) 脳 10-3 mm-2 s-1]. There was significant difference in ADC between uterine sarcoma and leiomyoma (P0.019). The ADC values of leiomyosarcoma and leiomyoma were overlapped in different subtypes of uterine sarcoma (P0. 018), and significant difference was found between leiomyosarcoma and leiomyoma (P0. 018). Conclusion DWI-MRI can provide necessary additional information for the diagnosis of uterine sarcoma on the basis of routine MRI. Quantitative analysis of ADC value is helpful to differentiate uterine sarcoma from uterine leiomyoma, but there is no significant difference in ADC value among different subtypes of uterine sarcoma.
【作者單位】： 復(fù)旦大學(xué)附屬婦產(chǎn)科醫(yī)院放射科;
【基金】：上海市衛(wèi)生與計(jì)劃生育委員會(huì)重點(diǎn)項(xiàng)目(20114011)~~
【分類號(hào)】：R737.33;R445.2

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