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Tiêu chuẩn chẩn đoán LNMTC theo Thomas J.K

Tiêu chuẩn chẩn đoán LNMTC theo Thomas J.K

Tải bản đầy đủ - 0trang

Tiêu chuẩn chẩn đoán LNMTC theo Thomas J.K

Thể khu trú:

* T2W:

• Khối hình bầu dục, giảm tín hiệu, ranh giới khơng rõ, trong

có các ổ nội mạc hoặc các khía nội mạc tăng tín hiệu

• Foci tăng tín hiệu, ĐK < 5 mm

* T1W:

• Khối đồng tín hiệu so với cơ tử cung xung quanh

• Ổ lạc nội mạc tăng tín hiệu khi chảy máu

* T1W+C:

• Mức độ ngấm thuốc thay đổi



Thomas J.K, Baert A.L (2007). "MRI and CT of the Female Pelvis". Springer; p70-102.



Lan toả không đối xứng



Lan toả đối xứng



Khu trú



Jha R.C et al (2003). "Adenomyosis: MRI of the Uterus Treated with Uterine Artery Embolization".

AJR; 181:851-856.



T1W: có ổ chảy máu



T1W+C



Ung thư cổ tử cung

• Carcinoma of the cervix is a malignancy

arising from the cervix and is considered the

third most common gynaecologic

malignancy (after endometrial and ovarian).



Epidemiology

•It typically presents in younger women with the average age of onset at

around 45 years. 

Risk factors

•human papillomavirus (HPV) 16 and 18 infection: for most types except

for clear cell carcinoma of the cervix and

mesonephric carcinoma of the cervix

•multiple sexual partners or a male partner with multiple previous or

current sexual partners

•young age at first intercourse

•high parity

•immunosuppression

•certain HLA subtypes

•oral contraceptives



Histological types



The main histological types are:

•squamous cell carcinoma of the cervix: accounts for the vast majority (80-90%) of cases

and is associated with exposure to human papillomavirus (HPV)

•adenocarcinoma of the cervix: rarer (5-20%) and can have several subtypes which include

– clear cell carcinoma of the cervix

– endometroid carcinoma of the cervix: ~7% of adenocarcinomas

– mucinous carcinoma of the cervix

• adenoma malignum: ~3% of adenocarcinomas

– serous carcinoma of the cervix

– mesonephric carcinoma of the cervix: ~3% of adenocarcinomas

•neuroendocrine tumours of the cervix

– small cell carcinoma of the cervix: rare (0.5-6%) 

•adenosquamous cell carcinoma of the cervix: rare



MRI



•The normal low signal cervical stroma provides intrinsic contrast for the

high signal cervical tumour.

•T1: usually isointense compared with pelvic muscles

•T2

– hyperintense relative to the low signal of the cervical stroma

– hyperintensity is thought to be present regardless of histological

subtype

•T1 C+ (Gd)

– contrast is not routinely used, though it may be helpful to

demonstrate small tumours considered for trachelectomy

– on contrast-enhanced T1-weighted images, tumour presents as a

high signal relative to the low signal of the cervical stroma



The FIGO staging system are determined by the

International Federation of Gynecology and Obstetrics

(Fédération Internationale de Gynécologie et d’Obstétrique).

In general, there are 5 stages:

•stage 0: carcinoma in situ (common in cervical, vaginal, and

vulval cancer)

•stage I: confined to the organ of origin

•stage II: invasion of surrounding organs or tissue

•stage III: spread to distant nodes or tissue within the pelvis

•stage IV: distant metastasis(es)



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