Hricak H, Tscholakoff D, Heinrichs L, Fisher M R, Dooms G C, Reinhold C, Jaffe R B
Radiology. 1986 Feb;158(2):385-91. doi: 10.1148/radiology.158.2.3753623.
Magnetic resonance (MR) imaging, symptoms, and pathologic findings were correlated in 59 uterine leiomyomas from 23 patients. The tumors varied from less than 1 cm to 18 cm in diameter. Fifty-seven leiomyomas were identified in the corpus uterus, one was located within the broad ligament, and another was detected in the cervix. Among the corpus lesions, 9 were correctly identified on MR images as subserosal and 37 as intramural. Of 11 tumors assigned at surgery to the submucosal group, 10 had been accurately defined with MR. On MR, myomas associated with hypermenorrhea produced an anatomic disruption of the "junctional zone" (the low-intensity band seen at the myometrium-endometrium junction on T2 contrast images). Long TR (2 sec) and TE (56 msec) parameters (T2 contrast images) yielded the best contrast resolution between leiomyoma and surrounding myometrium. Correlation of MR with histologic features demonstrated 2 groups of lesions. Leiomyomas free of degenerative changes emitted homogeneous signals of low intensity. Contrast between tumor and myometrium was -16% on the T1 contrast image and increased to -44 +/- 16% on the T2 contrast image. Leiomyomas with hyaline, myxomatous, or fatty degeneration demonstrated various degrees of inhomogeneity, best seen on images obtained with long TR and TE. It is concluded that MR is an accurate modality for imaging uterine leiomyomas, since it clearly demonstrates tumor number, size, location, and the presence and extent of degeneration.
对23例患者的59个子宫平滑肌瘤的磁共振（MR）成像、症状及病理结果进行了相关性分析。肿瘤直径从小于1厘米到18厘米不等。57个平滑肌瘤位于子宫体，1个位于阔韧带内，另1个在宫颈发现。在子宫体病变中，9个在MR图像上被正确识别为浆膜下肌瘤，37个为肌壁间肌瘤。在手术中判定为黏膜下组的11个肿瘤中，10个已被MR准确界定。在MR上，与月经过多相关的肌瘤使“结合带”（T2加权像上在肌层-内膜交界处所见的低信号带）出现解剖结构破坏。长TR（2秒）和TE（56毫秒）参数（T2加权像）在平滑肌瘤与周围肌层之间产生了最佳的对比分辨率。MR与组织学特征的相关性显示有两组病变。无退行性变的平滑肌瘤发出均匀的低强度信号。在T1加权像上肿瘤与肌层之间的对比度为-16%，在T2加权像上增至-44±16%。有透明样变、黏液样变或脂肪变性的平滑肌瘤表现出不同程度的不均匀性，在长TR和TE获得的图像上最明显。结论是，MR是子宫平滑肌瘤成像的一种准确方法，因为它能清楚地显示肿瘤数量、大小、位置以及退变的存在和程度。
