15例子宫阔韧带平滑肌瘤的磁共振信号特点分析

宋冬晓 赵素敏

摘要：目的：分析子宫阔韧带平滑肌瘤的磁共振信号特点。方法：对我院经手术及病理证实的15例子宫阔韧带平滑肌瘤的磁共振信号特点进行回顾性分析。结果：肿瘤位于双侧的有1例，左侧6例，右侧7例，上方1例;大部分病变与周围组织分界清;MRI信号主要表现为T1WI等低信号，T2WI混杂低信号或混杂高信号，DWI低或稍高信号，脂肪抑制序列均未见明确脂肪成分，增强扫描实性部分可见强化。结论：子宫阔韧带平滑肌瘤的MRI表现具有一定的特征性，能够在术前为临床提供定位及定性诊断，但最终确诊仍需依赖手术病理。

关键词：磁共振成像;子宫阔韧带;平滑肌瘤

中图分类号：R441.2;R737.33文献标识码：BDOI：10？郾3969/j.issn.1001-0270.2020.01.17

Abstract： Objective： Analysis of magnetic resonance signal characteristics of uterine broad ligament leiomyoma. Methods： The characteristics of magnetic resonance signals in 15 cases of uterine broad ligament leiomyoma confirmed by surgery and pathology were analyzed retrospectively. Results： There were 1 case on the bilateral side， 6 cases on the left， 7 cases on the right and 1 case on the top; most lesions are demarcated from the surrounding tissues; MRI signals are mainly characterized by low signals such as T1WI， T2WI mixed low signals or mixed high signals， DWI low or slightly high signals， fat inhibition sequences were not clear fat components， and enhanced scanning reality was partially enhanced. Conclusion： MRI findings of uterine broad ligament leiomyoma have certain characteristics and can provide clinical positioning and qualitative diagnosis before surgery， but the final diagnosis still depends on surgical pathology.

Key Words： MRI; Uterine Broad Ligament; Leiomyoma

阔韧带平滑肌瘤是妇科临床少见肿瘤，发病率约占妇科肿瘤的1‰-3‰[1]。其临床及影像表现缺乏特征性，术前诊断较为困难。本研究共收集15例经手术及病理证实的子宫阔韧带平滑肌瘤患者的临床和影像资料，分析其磁共振信号特点，探讨磁共振对子宫阔韧带平滑肌瘤的诊断价值，提高该病的术前诊断水平。

1 材料与方法

1.1 一般资料

收集我院自2013年9月至2019年3月间经手术及病理证实的子宫阔韧带平滑肌瘤共15例，年龄39岁-66岁，平均年龄52.1岁，临床症状以发现腹部肿块为主，部分患者出现下腹痛、下腹部坠胀感及腰痛。

1.2 检查方法

采用荷兰飞利浦公司生产的Ingenia3.0T磁共振仪，体部相控阵线圈。平扫主要序列參数包括横轴位：T1WI：TR=4ms，TE=2ms，层厚5mm，层间距-2.5mm;横轴位T2WI加脂肪抑制：TR=2800ms，TE=100ms，层厚6mm，层间距1mm;冠状位……