子宫内膜间质肉瘤的mri表现(附2例报告及文献回顾)

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1、子宫内膜间质肉瘤的MRI表现(附2例报告及文献回顾)【摘要】目的讨论子宫内膜间质肉瘤的MRI表现及特点，提高诊断水平。方法搜集我院2例及国外8例病理证实为子宫内膜间质肉瘤的病例，并回顾国外相关文献，讨论其MRI表现。结果肿瘤位于宫腔内6例，其中2例伴有壁结节，子宫壁3例，宫腔外1例。实性肿瘤、囊实性肿瘤、囊性肿瘤分别为5例、3例、2例。肿瘤多数较大，呈浸润性生长，7例直径大于5cm。肿瘤在MRI的TIWI多呈等信号，T2WI多呈高信号，伴有出血或坏死时信号不均呈混杂性。增强扫描实性肿瘤的主体部分强化明显，早期周围性强化，强化呈向心性，壁结节为早期并持续强化。囊实性肿

2、块的实性成分，囊性肿块的边缘和间隔部分多数强化明显，肿块可呈结节样周围强化或网格样强化。其中1例内膜及右侧输卵管壁弥漫受侵，并通过子宫圆韧带和阔韧带扩散至腹膜。伴有多发转移1例，伴有少量盆腔积液1例。结论子宫内膜间质肉瘤多数为宫腔内较大实性肿块，也可发生于肌壁或宫腔外，多呈浸润性生长，伴有出血、坏死、钙化时信号多不均匀呈混杂信号，增强扫描明显强化，MRI能为该病的诊断提供帮助。【关键词】子宫内膜间质肉瘤;MRI　[Abstract]ObjectiveTodiscussthemagneticresonanceimaging(MRI)findingsandfeature

3、sofendometrialstromalsarcomasandimprovethediagnosis.MethodsMRIimagesoftwocasesofmyhospitaland8casesofliteratureprovedbypathologywerestudiedwithreviewoftheliterature.Resultssixcaseslocatedinuterinecavity,2casesin6casesshowedmuralnodules,3caseslocatedinmyometrium,1caseextrauterineESS.5ca

4、sesSolidmass,3casessolid-cysticmass,2casescysticmass.Themasswasusuallylarge,showinginvasivegrowth,thediameterofthemassesismorethan5cm7cases.OnMRIimages,thesignalintensityofthemasswasofteniso-intenseonT1-weightedimagesandhyperintensityonT2-weightedimages.Thesignalintensityofthemassishet

5、erogeneouswithhemorrhageornecrosis.Solidmasseswereenhancedobviouslyaftertheadministrationofthecontrastmedium.Thepatternsofenhancementcanbeearlyperipheralcentripetalenhancement.Themuralnoduleshowedearlyenhancementandplateau.Thesolidcomponentsofcystic-solidmassandthemarginalandseptalwall

6、sofcysticmasswereenhancedobviouslyaftertheadministrationofthecontrastmedium.Thepatternsofenhancementcanbenodularperipheralenhancementorgrid-likeenhancement.1caseshowedthatadiffusepermeationfromadjacentmyometriumleadingtodiffusethickeningattherightfallopianwallwaspresent,whichwassustain

7、edthroughoutthebroadandroundligamentsandextendedtotheperitoneum.1casewithmultiplemetastasis,1caseshowedasmallamountofpelviceffusion.ConclusionMostofendometrialstromalsarcomaaresolidandlocateinuterinecavity,alsoinmyometriumorextrauterine,showinginvasivegrowth,thesignalintensitywashete