子宫肌瘤低场MRI表现及诊断价值（附24例分析）.docVIP

子宫肌瘤低场MRI表现及诊断价值（附24例分析） 　【摘要】 目的 探讨子宫肌瘤的低场MRI表现及其诊断价值。方法 对24例子宫肌瘤患者行MRI检查，SE序列，常规T1WI、T2WI及多方位成像，对其MRI表现进行回顾性分析。结果 18例多发肌瘤，5例单发肌瘤，MRI共检出41个病灶，所有病灶在T1WI上表现为等或低信号，在T2WI上表现为低或混杂信号。其中23例经手术治疗，1例行介入栓塞治疗。结论 低场MRI对子宫肌瘤在观察大小、形态、位置与子宫腔的关系和肌瘤在定性方面上有较高的诊断价值，可作为B超检查的重要补充手段。 【关键词】 子宫肿瘤；肌瘤；磁共振成像 Abstract： Objective To investigate the low-field magnetic resonance imaging (MRI) features of uterine leiomyomas and evaluate their diagnostic value. Methods Retrospective analysis was done on 24 patients with uterine leiomyomas who had undergone MRI examination including SE series, T1-weighted spin-echo imaging (T1WI) and T2-weighted fast spin-echo imaging (T2WI). Results Forty-one tumors were checked out. Of the patients, 18 suffered from multiple uterine leiomyomas, and 5 single leiomyoma. The tumors were presented as intermediate or low-intensity signals on T1WI and low or heterogenous-intensity signals on T2WI. The 23 patients were treated by surgical operation and the other one was intervened by embolism. Conclusion Low-field MRI is of high value in the diagnosis of uterine leiomyomas with respect to the confirmation of size, conformation, location, relationship with uterine cavity and nature, so it can be used as an important complementary diagnostic method to ultrasound. Key words： uterine neoplasm; leiomyomas; magnetic resonance imaging 子宫肌瘤通过临床检查结合超声、CT一般都能作出较准确诊断。随着MRI在临床上的逐渐普及，其对人体组织的高分辨率和多方位成像、大视野的优点已经显示出来，使子宫肌瘤病灶的检出、定位、定性的正确率得到了进一步提高，为诊断提供了更多的影像依据。同时MRI为无损伤、无电离辐射的检查手段，因而在妇科肿瘤的诊断中已成为重要手段之一，本研究对我院24例经手术病理或介入治疗诊断明确的子宫肌瘤患者的MRI资料进行分析，旨在探讨低场MRI对子宫肌瘤的表现及诊断价值。 1 资料与方法 1.1 一般资料 我科自2006年12月—2008年3月间我院收治的子宫肌瘤患者24例。年龄32～57岁，平均（42±0.5）岁。临床上患者以月经量增多、月经周期紊乱、下腹部坠胀、酸痛、贫血和腹部包块为主要症状来就诊。4例无任何症状和体征，是经超声体检偶然发现。 1.2 MRI扫描方法 采用GE Signa Profile/Gold永磁型开放式0.2T磁共振成像仪，患者取仰卧位，体线圈，SE序列分别进行横断面T1WI(TR 460 ms，TE13 ms)、T2WI(TR 3800 ms，TE 126.5 ms)、短恢复时间反转恢复法(short TI inversion recovery，STIR)(TR 4000 ms，TE37.5 ms)，矢状面T2WI或冠状面T2WI，层厚5~7 mm，间隔1 mm，视野38 mm，矩阵256×192，全部行平扫。 2 结果 本组24例中 18例多发肌瘤，6例单发肌瘤，MR