MRI在阴道斜隔综合征的术前诊断及临床分型中的应用价值  

Value of MRI in the pre-operative diagnosis and classification of oblique vaginal septum syndrome

作　　者：王悦[1] 林强[1] 孙智晶[2] 姜波[1] 侯波[1] 陆菁菁[1] 朱兰[2] 冯逢[1] 金征宇[1] 郎景和[2] Wang Yue;Lin Qiang;Sun Zhijing;Jiang Bo;Hou Bo;Lu Jingling;Zhu Lan;Feng Feng;Jin Zhengyu;Lang finghe(Department of Radiology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,100730 [2]中国医学科学院北京协和医学院北京协和医院妇产科,100730

出　　处：《中华妇产科杂志》2018年第8期534-539,共6页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的 探讨MRI在阴道斜隔综合征术前诊断及临床分型中的应用价值。方法 收集北京协和医院2014年7月-2016年12月经手术证实的阴道斜隔综合征患者共19例，回顾性分析19例患者的临床资料及术前MRI图像。由两位经验丰富的放射科医师在不了解手术结果的情况下共同评价术前MRI图像，并将MRI对疾病的诊断及分型结果与手术结果进行比较。结果19例阴道斜隔综合征患者的平均发病年龄为15岁（范围：9-25岁），平均初潮年龄为12岁；10例以痛经或下腹痛就诊，5例阴道异常排液，3例月经不规律，1例为原发性不孕。所有患者术前MRI检查均明确诊断阴道斜隔综合征。19例患者中，17例术前MRl分型结果与手术结果一致，包括Ⅰ型9例、Ⅱ型6例、Ⅲ型1例、Ⅳ型1例；2例术前MRl分型结果与手术结果不一致，包括1例Ⅱ型患者MRI误诊为Ⅰ型，1例Ⅰ型患者MRI误诊为Ⅲ型。术前MRI对阴道斜隔综合征的分型评估结果与手术结果的符合率为17／19。结论 MRI可明确诊断阴道斜隔综合征并能辅助评估其临床分型。Objective To explore the role of MRI in the pre-operative diagnosis and classification of oblique vaginal septum syndrome （OVSS）. Methods A retrospective analysis of the clinical records and pre-operative MRI images of 19 patients with surgery proved OVSS was carried out. Two experienced radiologists reviewed the pre-operative pelvic MRI of the 19 patients in consensus blind to the surgery results. Characteristics including malformations of the uterus, cervix and vagina, the diagnosis of the disorder and classification were evaluated. Pre-operative MRI diagnosis and classification were correlated with surgical findings. Results Mean age of onset of symptoms for the 19 patients was 15 years （ranged 9 - 25 years）, and mean age of menarche was 12 years. Ten patients suffered from dysmenorrhea or lower abdominal pain, 5 patients complained of vaginal discharge, 3 patients had a history of irregular menstruation, 1 patient suffered from primary infertility. All 19 patients showed uteri didelphys. Eighteen patients showed vaginal oblique septum.One patient showed cervical atresia.MRI was completely correlated with the surgery in the pre-operative diagnosis of OVSS. MRI classification was in line with surgery in 17 patients, including 9 patients with imperforate septum （type Ⅰ ）, 6 patients with perforate septum （type Ⅱ ）, 1 patient with imperforate septum and cervical fistula （type Ⅲ ）, and another one with cervical agenesis （type Ⅳ ）. One case of type Ⅱ was misdiagnosed as type Ⅰ , another one of type Ⅰ was misdiagnosed as type m Pre-operative MRI classification was correlated with surgery in 17 out of 19 patients. Conclusion Pre-operative MRI allows excellent manifestation and accurate diagnosis of OVSS, and could also facilitate the evaluation of the classification.

关 键 词：先天畸形 阴道 苗勒管 磁共振成像 阴道斜隔综合征 

分 类 号：R711.1[医药卫生—妇产科学]