MRI对子宫腺肌症的临床诊断应用  

Clinical Diagnosis of Adenomyosis with MRI

作　　者：叶璐[1] 冯亦军[1] 徐宏刚[2] 

机构地区：[1]广东省第二人民医院妇科,广东广州510317 [2]广州市第一人民医院放射科,广东广州510180

出　　处：《广州医学院学报》2008年第4期20-23,共4页Academic Journal of Guangzhou Medical College

摘　　要：目的:分析子宫腺肌症的MRI表现,探讨其在诊断中的价值。方法:回顾性分析本院本科室2003年1月-2007年12月43例经手术和病理证实的子宫腺肌症患者的MRI成像情况和临床资料。结果:43例子宫腺肌症患者MRI的表现:①弥漫性子宫腺肌症17例,表现为子宫均匀增大,轮廓光滑,T1WI病变为等信号,与正常肌层无法区分;T2WI上表现为低信号的结合带弥漫性均匀或不均匀增厚,增厚的结合带与内膜和外层肌之间界限不清。②局限性26例,T2WI上表现为与结合带信号相近的低信号肿块影,边界模糊,在T1WI平扫和增强病变均与肌层信号相仿。43例中,33例于T2WI低信号病灶中可见散在斑点状高信号灶,其中26例于T1WI上亦呈类似高信号灶,且其数量亦较T2WI上少。③有29例合并其它妇科疾病,其中子宫内膜异位症(卵巢巧克力囊肿)15例,子宫肌瘤9例,子宫内膜增生症4例,宫颈Nabothian囊肿1例。结论:MRI能够清晰显示子宫腺肌症病变,为子宫腺肌症的定性和定位诊断提供重要的参考依据,对其治疗有重要的指导作用。Objective： To evaluate the diagnostic value of adenomyosis with MRI. Methods： MRI features in 43 cases of adenomyosis confirmed by operation and pathology between January 2003 and December 2007 were studied retrospectively. Results： Among the 43 patients, ① 17 had diffuse adenomyosis, with enlarged, well-demarcated uterine by MRI. The lesions appeared isoechoic and not distinguishable from normal muscles on T1WI, while on T2WI, diffuse or local thickening of junctional zone were observed, or a local lump with indistinct margin in the exo-myometrium could be revealed; ② 26 had focal disease, on T2WI, the lesions were hypoechoic and ill-demarcated, similar to the junctional zone in signal intensity. On T1WI, non-enhancement or enhancement scanning revealed isoechoic lesions similar to muscles in signal intensity. Of the 43 patients, 33 showed hyperechoic spots amid hypoechoic lesions on T2WI, so did 26 patients on T1WI but the spots were less in quantity than those on T2WI. Twenty-nine patients were found to be complicated with other gynecological conditions, including 15 with endometriosis （chocolate cyst of ovary）, 9 with hysteromyoma, 4 with endometrial hyperplasia and 1 with cervical Nabothian cyst. Conclusion： MRI, with its distinct visualization of adenomyotic lesions, can be a very helpful modality in case identificationand localization of the disease, and thus providing important guidance for the treatment.

关 键 词：磁共振成像 子宫腺肌症 子宫疾病 信号 诊断 鉴别 应用 

分 类 号：R445.2[医药卫生—影像医学与核医学]