摘要
目的探讨葡萄胎(HM)的MRI表现,以进一步提高影像表现的认识。方法选取并分析14例经手术和病理证实的HM患者的临床及MRI资料。结果14例HM均表现子宫增大,病灶充盈宫腔。12例完全性葡萄胎(CHM)病灶呈T1WI等、稍低信号,T2WI等、高信号且内部多发大小不等边界清晰的囊状高信号,分布均匀;其中5例病灶局部含少量不同时期的出血信号。1例PHM病灶内部混有出血,T1WI、T2WI混杂信号,未见囊。另1例PHM病灶呈T1WI等、稍低信号,T2WI稍高信号且未见囊,病灶局部含出血信号。14例均显示宫腔少量出血信号。DWI低信号为主,部分出血部位表现为高信号。T2WI显示子宫蜕膜层、结合带清晰、连续,子宫肌层流空血管影。动态增强显示胚胎或胎盘附着部位清晰,呈血管样强化,附着部位子宫肌层血管增粗、强化,病灶逐渐强化,呈网状、条片状。延迟期病灶实性部分明显强化,囊性部分无强化。卵巢发现囊性病变6例。结论HM的MRI表现具有一定的特征性,为临床提供了更多诊断信息。
Objective This study analyzed the MRI manifestations of HM in order to further improve the recognition of imaging manifestations.Methods The clinical data and MRI of 14 cases of HM conformed by surgery and pathology were analyzed retrospectively.Results The lesions filled the uterine cavity and enlarged the uterus in all 14 cases of HM.There were 12 cases of CHM showing iso-or slight hypo-signal on T1WI and iso-or hyper-signal on T2WI,and 5 cases having a little hemorrhage of various periods in local areas,contained lots of hyper-signal cysts on T2WI,with inequality of size,clear edges and uniform distribution.1 case of PHM mixed with hemorrhage showed a complex signal on T1WI and T2WI,and no cyst.Another 1 case of PHM had no cyst showed iso-or slight hypo-signal on T1WI and slight hyper-signal on T2WI,and included hemorrhage in local areas.The lesions were hypo-signal on DWI in all cases except for some hemorrhage areas.The flow void of vessels in the myometrium and the continuity of the decidual layer and the junction zone of the uterus were displayed clearly on T2WI.During the early phases of dynamic contrast enhancement,the attachment sites of embryo or placenta were discovered and looked like vascular enhancement,and the blood vessels that were dilated and enhanced in the myometrium under the attachment sites were also displayed clearly.The lesions were gradually enhanced and exposed as nets and strips.The solid components were significantly enhanced,but cystic components had no enhancement in the delayed phase.Ovarian cysts were found in 6 cases.Conclusion MRI findings of HM have certain characteristics,which provide more information for clinical practice.
作者
赵维敬
梁宇霆
王新莲
ZHAO Weijing;LIANG Yuting;WANG Xinlian(Department of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, P.R.China)
出处
《医学影像学杂志》
2021年第6期1038-1041,共4页
Journal of Medical Imaging
基金
首都医科大学附属北京妇产医院中青年学科骨干培养专项(编号:fcyy201617)。
关键词
妊娠滋养细胞疾病
葡萄胎
磁共振成像
Gestational trophoblastic disease
Hydatidiform mole
Magnetic resonance imaging
