目的 探析子宫内膜样腺癌病理 表现并与MRI影像表现进行对照。方法 选 择我院2011年4月-2015年12月期间收治 16例子宫内膜样腺癌患者为例，均行MRI 检查。总结患者手术与病理表现及MRI影 像表现特点。结果 病理表现：外观均呈 不规则团块状肿物，12例为囊实性、4例 为实性。8例单纯型、6例复合型、2例混 合型。镜下肿瘤细胞呈现柱状，腺样或乳 头状排列，核大深染，分裂象较为常见。 MRI表现：病灶均存在占位效应，膀胱、 子宫、周围肠管等脏器受压移位，均伴腹 水。12例边界清晰、4例模糊。部分可见 多发纡曲血管、壁结节、囊液呈T1WI均匀 等或高信号、子宫内膜增厚。肿块直径在 3.7-16.3cm。MRI平扫结果示囊实性肿块 13例、实性肿块3例；增强扫描结果示13 例实性部分呈斑片状明显强化，3例轻、 中度强化。结论 子宫内膜样腺癌的 MRI 表现有一定特征性，平扫以囊实性肿块多 见，边界多清晰、可见腹水、占位效应明 显，部分可见壁结节、子宫内膜增厚，增 强扫描实性部分多呈斑片状明显强化，对 子宫内膜样腺癌的定位、定性及鉴别诊断 具有较大价值，确诊有赖病理检查。

Objective To explore the pathological manifestations of endometrial adenocarcinoma and to compare them with MRI findings. Methods 16 cases of patients with endometrial adenocarcinoma who were admitted in our hospital between April 2011 and December 2015 were included in the study all of whom were examined by MRI. Surgical and pathological manifestations and MRI findings were summarized. Results The pathological manifestations showed that there were irregular lumpy masses, 12 cases cystic and 4 cases solid. 8 cases were simple type, 6 cases of compound type and 2 cases of mixed type. Under the microscope, the tumor cells showed columnar, adenoid or papillary arrangement, with large nuclear deeply stained and mitotic figure was common. MRI findings: there was space occupying effect in all lesions. Bladder, uterus, peripheral intestine and other organs were pressed and shifted, with ascites. 12 cases were with clear boundaries and 4 cases with fuzzy ones. There were multiple tortuous blood vessels and wall nodules. Cystic fluid showed homogeneous equal or high signal on T1WI and endometrium thickened. The diameter of masses was 3.7-16.3 cm. MRI plain scan showed 13 cases of cystic solid mass and 3 cases of solid mass. Enhanced scan showed that 13 cases of solid parts were with patchy significant enhancement, 3 cases with mild and moderate enhancement. Conclusion MRI findings of endometrial adenocarcinoma have certain characteristics, and cystic and solid masses are common. Boundaries are clear and ascites and mass effect are obvious. There are wall nodules and endometrial thickening. After enhanced scan, the solid parts shows patchy significant enhancement, which is of great value in localization qualitation and differential diagnosis of endometrioid adenocarcinoma. Its diagnosis depends on pathological examination.