磁共振联合超声鉴别诊断子宫内膜间质肉瘤与变性子宫肌瘤-《中国医学物理学杂志》

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Title:: MRI combined with ultrasound in the differential diagnosis of endometrial stromal sarcoma and degenerative uterine fibroids

文章编号:: 1005-202X（2022）05-0562-05

作者:: 王艳华1; 李春晖1; 卜文瑾2; 张帆3; 申文凤1; 1.内蒙古医科大学附属医院超声诊断科，内蒙古呼和浩特 010050； 2.内蒙古自治区人民医院超声诊断科，内蒙古呼和浩特 010050； 3.内蒙古自治区人民医院病理诊断科，内蒙古呼和浩特 010050

Author(s):: WANG Yanhua1; LI Chunhui1; BU Wenjin2; ZHANG Fan3; SHEN Wenfeng1; 1. Department of Ultrasound Diagnosis, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China 2. Department of Ultrasound Diagnosis, Inner Mongolia Autonomous Region Peoples Hospital, Hohhot 010050, China 3. Department of Pathological Diagnosis, Inner Mongolia Autonomous Region Peoples Hospital, Hohhot 010050, China

关键词:: 子宫内膜间质肉瘤; 变性子宫肌瘤; 核磁共振; 直方图; 超声; 鉴别诊断

Keywords:: Keywords: endometrial stromal sarcoma degenerative uterine fibroids magnetic resonance imaging histogram ultrasound differential diagnosis

分类号:: R737

DOI:: DOI:10.3969/j.issn.1005-202X.2022.05.007

文献标志码:: A

摘要:: 目的：应用磁共振联合超声鉴别诊断子宫内膜间质肉瘤（ESS）与变性子宫肌瘤。方法：回顾性分析ESS患者19例和变性子宫肌瘤患者36例。分析患者磁共振直方图（T2WI肿瘤最大层面直方图）及彩超检测结果特征，并对两种方法联合诊断的灵敏度与特异度进行分析。结果与结论：ESS患者与变性子宫肌瘤患者临床表现近似，但各具特征；ESS患者年龄更高，绝经女性所占比例更高，且肿物最大直径相对更大。超声检测肿瘤基本特征可见，ESS患者肿瘤边界模糊的比例更高，以中强度回声为主，瘤体结构多为实性，血流丰富，红色样变比例也较高。对比之下，变性子宫肌瘤患者回声多为低强度，肿瘤结构多为其他结构，血流稀疏，脂肪样变比例相对更高。同时，受试对象MRI检测T2W1肿瘤最大层面直方图相关参数，在ESS患者和变性子宫肌瘤患者中可见在平均值、方差、偏度、峰度以及几个不同的百分位数（P1、P10、P50、P90）的差异均存在统计学意义（P<0.05）。直方图（P50）联合超声检查的灵敏度和特异度均较高，效力最佳。

Abstract:: Abstract: Objective To realize the differential diagnosis of endometrial stromal sarcoma (ESS) and degenerative uterine fibroids using magnetic resonance imaging (MRI) combined with ultrasound. Methods A retrospective analysis of 19 ESS patients and 36 patients with degenerative uterine fibroids was carried out. The characteristics of MRI histogram (T2WI tumor maximum slice histogram) and color Doppler ultrasonography were analyzed, and the sensitivity and specificity of the combined diagnosis were also evaluated. Results and Conclusion The clinical manifestations of ESS patients and patients with degenerative uterine fibroids are similar, but each has its own characteristics. Compared with patients with degenerative uterine fibroids, ESS patients are older and have larger maximum diameter of the tumor, and the proportion of menopausal women in ESS patients is higher. The basic characteristics of tumors can be detected by ultrasound. The proportion of blurred tumor borders in ESS patients is higher, and ESS is mainly dominated by medium-intensity echo, mostly solid, with abundant blood flow and higher proportion of red degeneration. In contrast, the echo of patients with degenerative hysteromyoma is mostly low-intensity, and the tumor is mostly classified into other structures, with sparse blood flow and higher proportion of steatosis. Meanwhile, MRI is used to detect the parameters related to the T2WI tumor maximum slice histogram, and the results revealed that there were differences in the average value, variance, skewness, kurtosis and several different percentiles (P1, P10, P50, P90) between ESS patients and patients with degenerative uterine fibroid, with statistical significance (P<0.05). The histogram (P50) combined with ultrasound has higher sensitivity and specificity, with the optimal effectiveness.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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