目的探讨巨大子宫肌瘤的多层 螺旋CT表现，旨在提高影像认识。方法 对26例(均行MPR重建；增强扫描12例)经 手术病理证实的巨大子宫肌瘤的CT资料 进行回顾性分析。结果 26例患者肿瘤最 大径线约9-35cm之间；位于子宫浆膜下 (n=8)、子宫阔韧带(n=5)、子宫肌壁间 (n=11)和子宫颈肌部(n=2)；平扫7例为均 质性，与子宫等密度，17例为非均质性， 2例为囊实混合性；CT增强扫描11例不均 匀明显强化，其内均可见多发细小血管 影，1例不均匀轻度强化。合并卵巢肿瘤 或囊肿6例，其中1例误诊为浆膜下子宫肌 瘤；7例表现不典型；11例病理证实肿瘤 内玻璃样变性，6例粘液样变性，2例囊性 变性。结论 巨大子宫肌瘤的多层螺旋CT 表现有一定特点，掌握其影像学特点有助 于提高诊断准确率；但对于部分不典型表 现的子宫肌瘤的诊断，应注意鉴别。

Objective To explore CT findings of giant uterine leiomyoma and to improve its diagnostic accuracy. Methods 26 patients of pathologically-proved giant uterine leiomyoma who had typical CT signs were selected (all cases had CT MRP reconstruction; 12 cases with enhanced scan). Results The maximal diameter of giant uterine leiomyoma ranged from 9-35 cm. The lesions located at subserous of uterus (n=8), the broad ligament (n=5), the myometrium (n=11), the uterus cervix (n=2). 7 cases demonstrated homogeneous density similar to normal uterus tissue on CT scans. 17 cases demonstrated heterogeneous density and the other 2 cases demonstrated cysticsolid mixed. 11 cases demonstrated obviously inhomogeneous enhancement with multiple small vessels observed; only 1 case demonstrated mild inhomogeneous enhancement. 6 cases were complicated by ovarian tumors or cysts, and 1 case was misdiagnosised. 7 cases demonstrated atypical CT findings. Pathology proved hyaline degeneration in 11 cases; 6 cases mucoid degeneration; 2 cases cystic degeneration. Conclusion Giant uterine leiomyoma have some characteristics in CT findings; grasps its images features is helpful for the diagnosis. However, atypical manifestation of giant uterine leiomyoma should be reminded to the differential diagnosis.