3.0T MRI在子宫肌瘤及子宫腺肌症中的鉴别诊断价值
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摘要
目的利用3.0TMRI对子宫结合带(junctional zone,JZ)形态、厚度及信号的准确评估,探讨3.0TMRI在子宫腺肌症(腺肌症组)与子宫平滑肌瘤鉴别诊断价值。方法回顾性比较分析经病理或临床综合证实的51例子宫腺肌症与84例子宫平滑肌瘤患者(肌瘤组)的子宫结合带3.0T MRI特征。2组病例均于T2WI压脂矢状位上观察JZ形态、信号变化,测出JZ厚度的最大值(JZmax)和最小值(JZmin),进行比较鉴别。结果子宫腺肌症组51例患者,JZ弥漫性增厚39例,局限性增厚12例,JZ厚度测量最大值(JZmax)厚度明显大于子宫肌瘤组(P<0.01)。腺肌症组与肌瘤组的(JZmin)无统计学差别(P>0.05)。腺肌症组51例患者,50例增厚区可见条或片状T2WI压脂高信号,18例JZ增厚区见小片状T1WI高信号。肌瘤组JZ均呈较均匀T2WI压脂低信号,未见明确T2WI压脂高信号或T1WI高信号。结论 3.0T MRI能准确评估子宫结合带形态、厚度及信号的变化,对于鉴别子宫腺肌症与子宫平滑肌瘤具有很高价值。
Objective To explore the application value of 3. 0 TMR in differential diagnosis between adenomyosis and leiomyoma by accurate assessment of morphous,thickness and signal on the junctional zone( JZ). Methods A total of 135 patients were divided into two groups; adenomyosis group( n = 51) and leiomyoma group( n = 84). The characteristics in JZ by MR images( 3. 0 T) were retrospectively analyzed. JZmax and JZmin were measured and compared according to the changes of JZ and signals on T2 WI pressure fat sagittal. Results The diffused thickness of JZ of the patients in adenomyosis group were detected in 39 patients and local thickness of JZ in 12 patients. The thickness of JZmax of patients in adenomyosis group was significantly higher than that in leiomyoma group( P < 0. 01). However there was no significant difference in JZmins between two groups( P > 0. 05). Flake or band T2 WI pressure fat high signals were detected in thickening area of 50 patients in adenomyosis group while small flake T1 WI high signals detected in JZ thickening area of 18 patients. T2 WI low pressure fat signals of JZ in leiomyoma group were relatively uniform. No clear T2 WI high signal and T1 WI high signal were detected.Conclusion 3. 0 TMRI can accurately assess the morphous,thickness and signals on junctional zone,which is highly valuable in differential diagnosis between adenomyosis and leiomyoma.
Objective To explore the application value of 3. 0 TMR in differential diagnosis between adenomyosis and leiomyoma by accurate assessment of morphous,thickness and signal on the junctional zone( JZ). Methods A total of 135 patients were divided into two groups; adenomyosis group( n = 51) and leiomyoma group( n = 84). The characteristics in JZ by MR images( 3. 0 T) were retrospectively analyzed. JZmax and JZmin were measured and compared according to the changes of JZ and signals on T2 WI pressure fat sagittal. Results The diffused thickness of JZ of the patients in adenomyosis group were detected in 39 patients and local thickness of JZ in 12 patients. The thickness of JZmax of patients in adenomyosis group was significantly higher than that in leiomyoma group( P < 0. 01). However there was no significant difference in JZmins between two groups( P > 0. 05). Flake or band T2 WI pressure fat high signals were detected in thickening area of 50 patients in adenomyosis group while small flake T1 WI high signals detected in JZ thickening area of 18 patients. T2 WI low pressure fat signals of JZ in leiomyoma group were relatively uniform. No clear T2 WI high signal and T1 WI high signal were detected.Conclusion 3. 0 TMRI can accurately assess the morphous,thickness and signals on junctional zone,which is highly valuable in differential diagnosis between adenomyosis and leiomyoma.
引文
1廉红梅,王燕,郎雁,等.两种手术方式对子宫腺肌病患者性生活满意度影响对比分析.中国实用妇科与产科杂志,2016,32:357-361.
2 Levy G,Dehaene A,Llaurent N,et al.An update on adenomyosis.Diagn Interv Imaging,2013,94:3-25.
3 曹泽毅主编.中华妇产科学.第3版.北京:人民卫生出版社,2014.1377-1378.
4 Aki Kido,Kaori Togashi.Uterine anatomy and function on cine magnetic resonance maging.Reprod Med Biol,2016,15:191-199.
5 He YL,Ding N,Li Y,et al.Cyclic changes of the junctional zone on 3 T MRI images in young and middle-aged females during the menstrual cycle.Clinical Radiology,2016,41:71-76.
6 Benagiano G,Brosena I,Hbaiba M.Adenomyosis:a life-cycle approach.Reprod Biomed Online,2015,30:220-232.
7 Amela S,Husic-Selimovic A,Aladin C,et al.The Significance of MRI Evaluation ofthe Uterine Junctional Zone in the Early Diagnosis of Adenomyosis.Original Paper/acta Inform Med,2016,24:103-106.
8 陆海迪,王长梅,强金伟,等.磁共振影像联合带厚度指标与T2WI高信号对子宫腺肌症的诊断价值.中国临床医学,2017,24:37-42.
9 Exacoustos C,Manganaro L,Zupi E.Imaging for the evaluationof endometriosis and adenomyosis.Best Pract Res Clin Obstet Gynaecol,2014,28:655-681.
10 Hamimi A.What are the most reliable signs for the radiologic diagnosis of uterine adenomyosis an ultrasound and MRI prospective.Egyp J Radiol Nucl Med,2015,46:1349-1355.
2 Levy G,Dehaene A,Llaurent N,et al.An update on adenomyosis.Diagn Interv Imaging,2013,94:3-25.
3 曹泽毅主编.中华妇产科学.第3版.北京:人民卫生出版社,2014.1377-1378.
4 Aki Kido,Kaori Togashi.Uterine anatomy and function on cine magnetic resonance maging.Reprod Med Biol,2016,15:191-199.
5 He YL,Ding N,Li Y,et al.Cyclic changes of the junctional zone on 3 T MRI images in young and middle-aged females during the menstrual cycle.Clinical Radiology,2016,41:71-76.
6 Benagiano G,Brosena I,Hbaiba M.Adenomyosis:a life-cycle approach.Reprod Biomed Online,2015,30:220-232.
7 Amela S,Husic-Selimovic A,Aladin C,et al.The Significance of MRI Evaluation ofthe Uterine Junctional Zone in the Early Diagnosis of Adenomyosis.Original Paper/acta Inform Med,2016,24:103-106.
8 陆海迪,王长梅,强金伟,等.磁共振影像联合带厚度指标与T2WI高信号对子宫腺肌症的诊断价值.中国临床医学,2017,24:37-42.
9 Exacoustos C,Manganaro L,Zupi E.Imaging for the evaluationof endometriosis and adenomyosis.Best Pract Res Clin Obstet Gynaecol,2014,28:655-681.
10 Hamimi A.What are the most reliable signs for the radiologic diagnosis of uterine adenomyosis an ultrasound and MRI prospective.Egyp J Radiol Nucl Med,2015,46:1349-1355.