盆腔子宫内膜异位症的CT、MRI诊断及误诊分析  

Analysis of the diagnosis and misdiagnosis of pelvic endometriosis with CT and MRI

作　　者：陈曌[1] 郑晓林[1] 郭友[2] 刘碧华[1] 

机构地区：[1]广东省东莞市人民医院放射科,广东523018 [2]广东省东莞市人民医院介入治疗科,广东523018

出　　处：《放射学实践》2015年第1期68-70,共3页Radiologic Practice

摘　　要：目的:探讨盆腔子宫内膜异位症的CT、MRI诊断价值。方法:回顾性分析经手术病理证实的29例盆腔子宫内膜异位症的CT、MRI表现,并与病理进行对照,着重分析误诊的病例。术前12例行CT扫描,17例行MRI检查。结果:光镜下见异位的子宫内膜与正常位置的子宫内膜相同,可见腺体及间质。行CT检查的12例中共误诊5例(41.6%),其中3例误诊为功能性囊肿,2例误诊为囊腺瘤。行MRI检查的17例中误诊1例(5.9%),误诊为双侧附件炎症。结论:CT、MRI可对盆腔子宫内膜异位症做出较准确的诊断,MRI诊断符合率高于CT。子宫内膜异位症需与功能性囊肿伴出血、囊腺瘤、附件炎症等鉴别。仔细观察影像征象,结合痛经病史,可提高诊断符合率。Objective：To study the value of CT and MRI in the diagnosis of pelvic endometriosis.Methods：A retrospective analysis of the CT and MRI features in 29 cases with pathology proven pelvic endometriosis were performed,the imaging findings were correlated with pathology,and concentration was placed at those misdiagnosed cases.Twelve cases underwent CT scanning and 17 cases had MRI before surgery.Results：The ectopic endometria contained normal endometrial glands and stroma,which was the same as normal endometrium under light microscope.Of the 12 cases with CT,5cases（41.6%）were misdiagnosed.Of which,3cases were misdiagnosed as functional cyst and 2cases as cystadenoma.One case（5.9%）was misdiagnosed as bilateral adnexitis.Of the 17 cases with MRI scan,only 1case was misdiagnosed as bilateral adnexitis.Conclusion：Pelvic endometriosis can be accurately diagnosed on CT and MRI.However,the accuracy of MRI was higher than that of CT.Differential diagnosis included functional cyst accompanied with hemorrhage,cystadenoma and adnexitis.Accuracy of diagnosis could be improved by careful observation of imaging features,in combination with the understanding of history of dysmenorrheal.

关 键 词：盆腔 子宫内膜异位症 体层摄影术 X线计算机 磁共振成像 

分 类 号：R711.71[医药卫生—妇产科学] R816.91[医药卫生—临床医学] R445.2