The diagnostic value of MRI in invasive lesions originating from uterine smooth muscle
10.3969/j.issn.1002-1671.2024.03.017
- VernacularTitle:MRI在子宫平滑肌起源侵袭性病变中的诊断价值
- Author:
Liming CHANG
1
;
Lili SHI
Author Information
1. 唐山市工人医院放射科,河北 唐山 063000
- Keywords:
uterus;
smooth muscle;
magnetic resonance imaging
- From:
Journal of Practical Radiology
2024;40(3):417-421
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the MRI findings of invasive lesions originating from uterine smooth muscle,and to improve the preoperative accurate diagnosis ability.Methods A total of 29 patients with invasive tumors originating from uterine smooth muscle and confirmed by surgery and pathology were selected and divided into benign group and malignant group.The shape of the lesion and the signal characteristics of MRI sequences were analyzed retrospectively,the apparent diffusion coefficient(ADC)values of solid components of lesions were measured,and the ADC values of different tumors were compared.Independent sample t test was used for statistical analysis.Results A total of 26 cases were correctly diagnosed by MRI,and the diagnostic accuracy rate was 89.7%.Eighteen cases of intravenous leiomyomatosis(IVL)had a history of uterine fibroid,extrauterine lesions showed sausage or nodular-shaped with slightly higher signal on T2WI,equi signal on T1WI and diffusion weighted imaging(DWI),dynamic enhanced scanning sequence showed synchronous enhancement with myometrium of uterus;Two cases of leiomyomatosis peritonealis disseminate(LPD)had a history of uterine fibroid,solid cystic masses were found in the uterus,solid components showed equivalent or slightly higher signal on T2WI,equi signal on T1WI,equivalent or slightly higher signal on DWI,multiple solitary nodules were found in pelvic wall,uterus and rectum fossa,mesentery and omental sac,with uniform signal and clear boundary,equi signal on T2WI,T1WI and DWI,dynamic enhanced scanning sequence showed synchronous enhancement with myometrium of uterus,strengthening uniform;Of the 9 cases of leiomyosarcoma,8 cases showed solid cystic masses with T1WI high signal bleeding focus,solid components showed slightly higher signal on T2WI,equi signal on T1WI,obvious higher signal on DWI,the boundary of the mass was unclear,and the enhancement was uneven after enhancement;There were 20 cases in benign group,including 18 cases of IVL and 2 cases of LPD,the mean ADC values were(1 357.06±74.55)×10-3mm2/s,the malignant group was leiomyosarcoma,the mean ADC values were(849.56±22.80)×10-3mm2/s,there were statistical difference between the groups(P<0.05).Conclusion The MRI findings of invasive tumors originating from uterine smooth muscle are dif-ferent,the measurement of ADC value can be used as a quantitative diagnostic basis for benign and malignant determination.