目的研究CT平扫在巨大子宫肌 瘤中的应用价值。方法 随机选取我院 2011年12月至2014年9月经病理确诊的巨 大子宫肌瘤患者67例为研究对象，以GE LightSpeed 64排螺旋CT进行检测，67例 患者中44例仅行平扫，23例采取平扫联合 双期增强扫描，后期图像通过GE ADW4.4 工作站分析，主要观察肿瘤病变部位、形 态、密度。结果 19例子宫肌瘤处于浆膜 下，15例为宫颈肌部，33例处于肌壁间， 单发37例，多发30例，其中14例患者术前 未明确肌瘤部位。67例患者有51例清晰显 示病灶边界，16例边界不清，CT扫描肌瘤 形态包括不规则形3例、分叶状3例、椭圆 形14例、类圆形31例。21例宫腔变形移 位、显示模糊，30例肿瘤生长已超过骨盆 高度；15例为均质性肿块，CT显示密度为 35-60Hu，32例为非均质肿块，增强扫描 23例患者中21例表现为不均匀中、重度强 化，均可见细小血管影。结论 CT平扫在 巨大子宫肌瘤中有较高的应用价值，可观 察巨大子宫肌瘤大小、部位、是否合并出 血坏死囊变、及其与周围脏器的关系，对 手术治疗起指导作用。

Objective To study the application value of CT diagnosis of giant uterine leiomyomas. Methods A total of 67 patients confirmed of giant uterine leiomyomas admitted in to the hospital during December 2011 to September 2014 were selected as the research objects. The GE LightSpeed 64-row spiral CT were used for detection. Among the 67 cases of patients, there were 44 cases of patients who only received plain scan and 23 cases received plain scan combined with dual-phase enhanced scan. The images were later analyzed through GE ADW4.4 workstation, mainly to observe the lesion location, morphology and density of tumors. Results There were 19 cases of uterine leiomyomas located below serous membrane, 15 cases in cervical muscle and 33 cases in muscular wall. Single lesion was found in 37 cases and multi-lesions in 30 cases including 14 patients without confirmed sites of leiomyoma. Fifty cases with clear lesion boundaries and 16 cases with unclear boundaries. The shapes of leiomyoma included irregular shape (3 cases), lobulated(3 cases), oval shape(14 cases) and round shape(31 cases). The deformity and displacement of uterine cavity in 21 cases of patients was relatively fuzzy. The growth of 30 cases of tumors exceeded the height of the pelvis A total of 15 cases showed homogeneous masses with the density of 35-60Hu, and 32 patients showed heterogeneous masses. Among the 23 patients who received enhanced scan, there were 21 cases manifesting as uneven and severe enhancement, with visible small blood vessel shadow. Conclusion CT scan is of high value in the analysis of giant uterine leiomyomas, which can observe the size, location, complicated with hematoma, necrosic,or cystis degeneration or not, and the relationship with the surrounding organs of giant uterine leiomyomas, which may be the guidance for surgical treatment.