宫内早孕的MRI表现  

MRI manifestations of early intrauterine pregnancy

作　　者：江魁明[1] 李冰[1] 彭唏[1] 董天发[1] 李志钊[1] 

机构地区：[1]广州医学院附属市二人民医院CT&MRI室,广东广州510150

出　　处：《中国医学影像技术》2004年第10期1581-1584,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的　探讨宫内早孕的MRI表现 ,评价MRI对早孕的诊断价值。方法　回顾分析人流术后经病理证实的 3 5例宫内早孕的MRI、超声表现。结果　早孕胚胎、胎儿的MRI表现呈囊性结构 ;以蜕膜信号为参照 ,早早孕孕囊壁呈等T1、短T2信号 ,早中期、早后期孕囊壁呈短T1、短T2信号 ;T1WI ,2 8例 (80 % )孕囊可见胚胎 /胎儿结构 ,T2WI上 16例胚胎 /胎儿结构与孕囊液呈高信号 ,不能区分 ;MRI显示早早孕、早中期的卵黄囊、胚外体腔、羊膜囊及胎心搏动不如超声 (P<0 .0 0 5 ) ;7例 (2 0 % )孕囊壁和蜕膜间点状慢性出血 ;2 9例 (82 .9% )子宫肌层和结合带T2WI出现结节状低信号。结论　MRI对宫内早孕诊断有极高的敏感性、特异性 ,显示胚胎细微结构不如超声 ;Objective To study MRI manifestations and diagnostic value of early intrauterine pregnancy. Methods MRI and ultrasound manifestations of early intrauterine pregnancy of 35 cases were retrospectively analyzed. All cases were proved pathologically after artificial abortion (18 cases early-early period of early pregnancy, 13 cases middle-early period and 4 cases late-early period), and there was only one gestational sac in each case. Urinary HCG' s test, ultrasonography and MRI were performed in the same day and the artificial abortion was performed one day after the diagnosis of early pregnancy. Results Embryos and fetuses appeared as cysto-structures. In comparison with decidual signal, gestational sacs' walls appeared as isointense signal on T1WI and hypointense signal on T2WI in early-early period, hyperintense signal on T1WI and hypointense signal on T2WI in middle-early period and late-early period. Embryonic / fetal structures of 28 cases (80%) of early pregnancy were showed on T1WI, among them the embryonic / fetal structures of 16 cases appeared as hyperintensity on T2WI, and they were not differentiated from gestational sacs' fluid. Ultrasonography had great advantage over MRI in showing yolk sacs, amniotic sacs, extraembryonic coelom and embryocardia-beats ( P <0.005). There was patchy bleeding between gestational sacs' walls and decidua in 7 cases (20%). Nodular area of hypointense signal in myometrial and junctional zone was found on T2WI in 29 cases (82.9%). Conclusion MRI has very good sensitivity and specificity in the diagnosis of early pregnancy. Ultrasonography has great advantage over MRI in showing embryonic structures. Hypointense signal of the gestational sacs' walls on T2WI is a characteristic sign of the gestational sacs.

关 键 词：妊娠初期 磁共振成像 超声检查 

分 类 号：R714.15[医药卫生—妇产科学] R445.2[医药卫生—临床医学]