目的 探讨子宫恶性中胚叶混合瘤(MMMT)的MRI表现.方法 回顾性分析9例病理确诊为MMMT患者的临床及影像资料,分析MRI表现.结果 9例肿瘤中6例位于宫体,3例位于宫颈；宫体和宫颈肿瘤形态不同,位于宫体的肿瘤呈膨胀性生长或浸润性生长,伴宫腔不同程度扩张；位于宫颈的肿瘤向阴道外生性生长,不伴肌层浸润；在T1WI肿瘤均表现为等或稍低信号,在T2WI二者信号存在一定差异,位于宫体的肿瘤T2WI以混杂高信号为主(5例),肿瘤内部可见出血(1例)及囊变、坏死信号(5例)；而位于宫颈的肿瘤T2WI为稍高信号,内可见条索样或树枝样低信号,病变内部未见明显出血及坏死；以子宫肌层的强化程度作为参照,位于宫体的肿瘤强化较位于宫颈肿瘤强化明显且不均匀.结论 宫颈和宫体MMMT生长方式、MRI信号及增强特点存在一定差异,MRI对术前准确诊断有帮助.
Objective To explore MRI appearances of malignant mixed mesodermal tumors (MMMT) of the uterus. Methods All 9 patients with MMMT were proved by pathology. MRI characteristics of MMMTs in 9 patients were analyzed retrospectively.Results Of 9 MMMTs,6 were uterus body-based and 3 were cervical-based.Body-based MMMTs tended to be expansive or infiltrative growth with expanded uterus cavity. Cervical-based.MMMTs tended to be exophytic growth without myometrial infiltration. The tumors presented iso- or low signal on T1WI. The body-based MMMTs presented heterogeneously hyper-intense on T2WI ( n =5 ),hemorrhage ( n =1 ),cystic degeneration and necrosis (n =5) were seen within the tumors. Cervical-based MMMTs presented relative hyper-intense signal on T2WI with band or tree-like hypo-intense signal,without hemorrhage and necrosis. Body-based MMMTs were enhanced more obviously than cervical-based MMMTs.Conclusions The growth pattern,MRI signal and enhancement characteristics of cervix and uterus body MMMTs are different. MRI is helpful for the diagnosis of MMMT.