子宫腺肌病的MRI诊断  

MRI diagnosis of adenomyosis

作　　者：杜龙庭[1] 陈辉[1] 陈小伟[1] 朱襄明[1] 李军[1] 

机构地区：[1]襄樊市中心医院放射影像科磁共振室,湖北441021

出　　处：《放射学实践》2011年第2期202-204,共3页Radiologic Practice

摘　　要：目的:评价MRI对子宫腺肌病的诊断价值。方法:回顾性分析28例经手术病理证实的子宫腺肌病的MRI表现。结果:术前MRI均明确诊断。所有病例均表现子宫体不同程度增大,以后壁增大为明显。弥漫型子宫腺肌病10例:T1WI呈等信号,其中2例病变内可见点状高信号;T2WI呈稍低信号,其中6例病变内见散在的点状或小片状高信号,矢状面T2WI示子宫结合带弥漫性增厚,平均17 mm。局限型子宫腺肌病18例:表现为肌层内单发或多发不规则形或圆形肿块状异常信号,直径2.1～8.5 cm,平均3.7 cm,病灶均与周围肌组织分界不清,T1WI呈等信号,其中9个病灶内可见点状高信号;T2WI呈稍低信号,其中13个病灶内见散在点、小片状高信号。20例行DWI检查,其中18例显示散在的多发点状或斑片状高信号,较T2WI显示清晰且高信号灶较T2WI为多。结论:MRI是诊断子宫腺肌病的无创性检查方法,子宫腺肌病的MRI表现具有特征性,合理选择扫描序列,有助于该病的术前诊断。Objective：To investigate the value of MRI in the diagnosis of adenomyosis.Methods：MRI findings of 28 cases with surgically and histologically proved adenomyosis were retrospectively analyzed.Results：Definite diagnosis was made in 28 cases by preoperative MR.All findings of these cases showed enlargement of the uterine body in different degrees,more obviously in the posterior walls.10 cases were diffuse adenomyosis：they appeared as iso-intensity on T1WI,2 of them with punctate hyperintensity.On T2WI these 10 cases showed slight hypointensity,6 of 10 cases showed punctate or patchy hyperintensity.On sagittal view of T2WI the uterine junction zone was thickened with a mean thickness of 17mm.18 cases were localized adenomyosis：irregular or round shape lesions were shown in the muscular layer,diameter between 2.1 and 8.5cm with a mean of 3.7cm,and boundaries of the lesions and the surrounded muscular tissues were unclear.The lesions showed iso-intensity on T1WI,and there was as spunctate hyperintensity in 9 cases of them.They appeared as slightly hypointensity on T2WI,13 of them appeared as internal interspersed punctate,patchy hyperintensity.DWI was performed in 20 cases,and 18 of them showed interspersed punctate,patchy hyperintensity,which was more and clearer than the lesions shown by T2W.Conclusion：MRI is an non-invasive method in the diagnosis of adenomyosis.Adenomyosis has its own specific manifestations on MRI,and MRI is helpful in making the diagnosis of adenomyosis with rational sequences.

关 键 词：子宫疾病 子宫内膜 磁共振成像 

分 类 号：R711.74[医药卫生—妇产科学] R445.2[医药卫生—临床医学]