正常女性子宫和卵巢周期性变化的MRI研究  

MR Imaging of the Uterus and Ovaries in Healthy Women： Morphological Changes during the Menstrual Cycle

作　　者：强金伟[1] 邱海英[1] 李若坤[1] 廖治河[1] 蒋春梅[1] 

机构地区：[1]复旦大学附属金山医院放射科,上海200540

出　　处：《实用放射学杂志》2009年第2期207-211,共5页Journal of Practical Radiology

摘　　要：目的研究健康女性子宫、卵巢的形态和结构周期性变化规律。方法15名身体健康、月经周期规则的育龄女性志愿者,于经期、经末、排卵前、排卵后和经前期共5个期分别进行盆腔MR扫描。观察和测量子宫形态和大小,内膜、联合带、外肌层厚度,双侧卵巢大小、形态和结构,卵泡数目、最大卵泡直径。结果在T2WI像上,子宫内膜表现为均匀高信号,联合带为均匀低信号,外肌层为编织状纹理的略高信号。子宫高径、内膜和外肌层厚度经前大于其他各期,联合带厚度各期差异无统计学意义。在T2WI像上,卵巢可见明显的分区结构,皮质表现为与子宫肌相似的等信号,髓质信号略高于皮质。在皮髓质间,可见大小不等、环样排列、信号非常高的囊性卵泡,最大径0.37～3.10cm,平均1.16cm,排卵后卵泡最大,平均为1.56cm。经前期卵巢髓质最厚。盆腔积液很常见,排卵后出现率最高。结论MRI能清晰地显示子宫和卵巢的细微解剖结构,有助于病变的早期发现和诊断。Objective To investigate morphological changes of the normal uterus and ovaries in healthy women during the menstrual cycle. Methods Fifteen healthy women with normal ovulatory cycles underwent pelvic MR imaging at five periods including mid--（day 3）,post--menstruation （day 7）, pre-- （day 12） and post--ovulatory（ day 17 ） , and pre--menstruation phase（ day 27） . The uterine and ovarian morphology, the thickness of the endometrium, junctional zone and myometrium, the number of ovarian follicle and the largest ovarian follicles were determined on MR images. Results The homogeneous high and low signal intensity of endometrium and junctional zone respectively and slight high signal of myometrium were demonstrated on T2 WI. The thickness of uterus, endometrium and myometrium, but not junctional zone, were larger at pre--menstruation than those at other phases. T2 WI provided the best delineation of the ovarian zonal anatomy with low-- signal cortex which was comparable to the myometrium and slight hyperintensity, heterogeneous medulla. Between the cortex and the medulla, embeded numerous, various size, ring--aligned and very high--signal follicles whose largest diameter ranged from 0.37 cm to 3.10 cm with mean diameter 1.16 cm. The largest follicles were seen at post--ovulatory phase with mean diameter 1.56 cm. The pelvic fluid appeared frequently with highest prevalence at post--ovulatory phase. Conclusion MR imaging can demonstrate clearly the fine architecture of the uterus and ovary and that is helpful in early identifying the lesions.

关 键 词：盆腔 子宫 卵巢 月经周期 磁共振成像 

分 类 号：R711.51[医药卫生—妇产科学] R445.2[医药卫生—临床医学]