目的 探讨MRI在鉴别子宫肉瘤 与变性子宫肌瘤的应用价值。方法 回 顾分析我院经组织病理学证实的24例子 宫肉瘤和32例变性子宫肌瘤患者临床资 料及影像学资料，所有患者均接受动态 增强MRI检查，比较两组成像特点，分 析病灶的表观扩散系数(ADC)、最大对 比增强率(MCER)及时间-信号强度曲线 (TIC)类型，并观察不同子宫肉瘤间的差 异。结果 术前MRI检查显示子宫肉瘤确 诊率100.0％，变性子宫肌瘤者确诊率 96.42％，差异无统计学意义(P>0.05)； 子宫肉瘤组ADC值(0.84±0.08)10 - 3 m m 2 /s，TTP值(43.85±5.13)s， MCER(241.63±43.65)，明显低于 变性子宫肉瘤组(1.42±0.15)10 - 3 m m 2 /s，TTP值(54.26±4.53)s， MCER(143.14±16.83)，差异均具有统计 学意义(P<0.05)；子宫肉瘤组21例TIC呈 I型，2例II型，1例I型；变形子宫肌瘤 中，26例TIC呈I型，6例呈II型，无III 型TIC，差异无统计学意义(P>0.05)。结 论 子宫肉瘤及变性子宫肌瘤者MRI图像 均可呈现T2WI高信号，但子宫肉瘤者ADC 值、TTP及MCER值均明显低于变性子宫肌 瘤者，MRI可有效鉴别子宫肉瘤与变形子 宫肌瘤，临床可结合不同MRI序列值进行 疾病诊断。

Objective To explore the application value of MRI in the differential diagnosis of uterine sarcoma and denatured uterine fibroids. Methods The clinical data and imaging data of 24 cases of patients with uterine sarcoma and 32 cases of patients with denatured uterine fibroids proved by histopathology in our hospital were retrospectively analyzed. All patients were given dynamic contrast-enhanced MRI examination, and the imaging features were compared between the two groups. The apparent diffusion coefficient (ADC), maximum contrast enhancement rate (MCER) and time-signal intensity curve (TIC) of the lesions were analyzed, and the differences among different uterine sarcomas were observed. Results The preoperative MRI examination showed that the diagnosis rate of patients with uterine sarcoma was 100.0%, and the diagnosis rate of patients with denatured uterine fibroids was 96.42%, therefore the difference was not statistically significant (P>0.05). The values of ADC (0.84±0.08)10-3mm2 /s, TTP (43.85±5.13)s and MCER (241.63±43.65) in the uterine sarcoma group were significantly lower than those of the denatured uterine fibroids group with (1.42±0.15)10-3mm2 /s, TTP (54.26±4.53) s, MCER (143.14±16.83), therefore the difference was statistically significant (P<0.05). There were 21 cases of TIC type I and 2 cases of type II and 1 case of type I in the uterine sarcoma group, and there were 26 cases of TIC type I, 6 cases of type II, and no TIC type III in the denatured uterine fibroids, but the difference was not statistically significant (P>0.05). Conclusion MRI images of uterine sarcoma and denatured uterine fibroids can be presented high signal of T2WI, but the values of ADC, TTP and MCER in patients with uterine sarcoma are significantly lower than those in the patients with denatured uterine fibroids. And MRI can effectively identify uterine sarcoma and denatured uterine fibroids, therefore different MRI sequence values can be combined for the clinical disease diagnosis.