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子宫神经内分泌癌与子宫恶性淋巴瘤的 MRI 表现比较。

Comparison of MR imaging features of uterine neuroendocrine carcinoma and uterine malignant lymphoma.

机构信息

Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Osaka, 545-8585, Japan.

Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.

出版信息

Abdom Radiol (NY). 2019 Oct;44(10):3377-3387. doi: 10.1007/s00261-019-02201-1.

Abstract

PURPOSE

We retrospectively investigated the characteristic magnetic resonance (MR) imaging findings of uterine neuroendocrine carcinoma (UNEC) compared to those of uterine malignant lymphoma (UML).

METHODS

Nine consecutive female patients with UNEC and 5 female patients with UML participated in this study. MR imaging features were evaluated retrospectively.

RESULTS

On MR imaging, seven of 9 UNEC lesions and no UML lesions showed an exophytic growth pattern. All 9 UNEC lesions and no UML lesions showed a growth pattern along the surface of the endocervix or endometrium. Only 1 UNEC lesion and all 5 UML lesions showed diffuse enlargement of the uterus. No UNEC lesions and all 5 UML lesions showed a multinodular shape. These findings showed significant differences between lesions. Findings for margin, endophytic growth pattern, signal intensity, and homogeneity on T2-weighted and T1-weighted imaging did not differ significantly between lesion types. Apparent diffusion coefficient was significantly lower for UML lesions than for UNEC lesions, but was quite low for both types. Local invasion to surrounding tissues was more frequent in UML lesions than in UNEC lesions. There was no significant difference in the frequency of lymphadenopathy between two entities.

CONCLUSIONS

UNEC lesions tended to show an exophytic growth pattern and growth along the surface of the endocervix or endometrium, even when diffuse enlargement of the uterus was present, while all UML lesions showed a multinodular shape and diffuse enlargement of the uterus without thickening of the cervical epithelium and endometrium.

摘要

目的

本研究回顾性分析了子宫神经内分泌癌(UNEC)与子宫恶性淋巴瘤(UML)的磁共振成像(MRI)特征。

方法

本研究连续纳入了 9 例女性 UNEC 患者和 5 例女性 UML 患者,回顾性评估了 MRI 特征。

结果

9 例 UNEC 病变中的 7 例和 5 例 UML 病变均表现为外生性生长方式。所有 9 例 UNEC 病变和 5 例 UML 病变均沿宫颈内膜或子宫内膜表面生长。仅 1 例 UNEC 病变和 5 例 UML 病变表现为子宫弥漫性增大。所有 UNEC 病变均表现为单结节状,而 5 例 UML 病变均表现为多结节状。这些表现提示病变间存在显著差异。病变边界、向腔内生长方式、T2 加权像和 T1 加权像信号强度及均匀性方面的表现,在不同病变类型间无显著差异。UML 病变的表观扩散系数明显低于 UNEC 病变,但两者均较低。UML 病变的局部侵犯周围组织更为常见,而淋巴结病变的发生率在两种病变间无显著差异。

结论

UNEC 病变表现为外生性生长方式,即使出现子宫弥漫性增大,仍沿宫颈内膜或子宫内膜表面生长,而所有 UML 病变均表现为多结节状及子宫弥漫性增大,不伴有宫颈上皮及子宫内膜增厚。

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