【摘要】 目的　研究阔韧带平滑肌瘤的影像诊断。方法　回顾性总结 9例经手术和病理证实为阔韧带平滑肌瘤的B超、CT及MRI表现。结果　 9例B超检查表现为盆腔内、子宫外实性肿块 ,呈低回声灶 ,4例内有斑点状液性暗区或不均匀光点 ,5例显示包膜 ,7例边界清晰。 8例CT检查 7例表现为实性肿块 ,边界较清晰 ,平扫密度较均匀 ,与子宫肌密度相当或稍低 ;1例为混合密度灶 ,可见液化、坏死与囊变 ;8例增强扫描实性部分均见明显强化 ,4例可见斑点、片状不强化灶。 2例MRI表现肿块包膜完整 ,与周围脏器分界清晰 ,T1WI为等或略低信号、T2 WI为中等信号 ,内间杂斑点、条状高信号灶 ,注射钆喷替酸葡甲胺 (Gd DTPA)后肿块明显强化 ,其内有斑点状不强化灶 ,包膜显示更清晰、无强化。结论　影像检查 (B超、CT、MR)发现盆腔内、子宫外大而有完整包膜的实性或以实性为主的肿块是阔韧带平滑肌瘤的较具特征的征象 ,对诊断有重要意义。MRI具有良好的软组织分辨率、多方位成像的特点 ,加上脂肪抑制技术 ,有利于显示肿块的成分与包膜 ,对诊断有较大的帮助。最后确诊有赖于手术和病理检查更多还原

【Abstract】 Objective To study imaging diagnoses of the broad ligament leiomyoma Methods The findings of ultrasound, computed tomography and magnetic resonance imaging of 9 cases with broad ligament leiomyoma were retrospectively analyzed The diagnosis was proved by operation and pathology Results The findings of ultrasound were pelvic and extrauterine solid hypoechoic masses in all cases There were patchy fluid areas or inhomogeneous hyperechoic points in 4 case, capsule in 5 cases and clear margin in 7 cases Among 8 cases of CT examination, there were solid masses in 7 cases with clear border and homogeneous density similar to uterus muscles and mixed masses in 1 case on plain CT scan The masses were obviously enhanced on contrast enhanced CT scan There were inhomogeneous patchy and non enhanced areas in the tumor in 4 cases MR was obtained in 2 cases, which demonstrated masses with capsule and clear border These tumors had a signal of intermediate or slightly low intensity on T 1 weighted images, while on T 2 weighted images an intermediate signal intensity of the masses with patchy and stripe hyperintense areas were seen The masses were obviously enhanced with patchy non enhanced areas after intravenous Gd DTPA injection Conclusion The detection of a large, solid mass by ultrasound, CT or MR in extrauterine pelvis with capsule indicates broad ligament leiomyoma MR possesses good soft tissue resolution, multi direction imaging and the fat suppression technique which can demonstrate the capsule, inner structure of the tumor, and help establish the diagnoses更多还原