磁共振成像在孕早期瘢痕妊娠子宫收缩中的诊断与鉴别诊断价值  

The value of MRI in the diagnosis and differential diagnosis of uterine contraction in the first trimester caesarean scar pregnancy

作　　者：贾慧茹 张翼 宜继红 张静 JIA Huiru;ZHANG Yi;YI Jihong;ZHANG Jing(Department of Medical Imaging,Yuncheng First Hospital,Yuncheng,Shansi Province 044000,China;Imaging Center Northwest Women and Children's Hospital,Xi'an 710061,China)

机构地区：[1]运城市第一医院医学影像科,山西运城044000 [2]西北妇女儿童医院医学影像中心,陕西西安710061

出　　处：《实用放射学杂志》2020年第11期1806-1808,1812,共4页Journal of Practical Radiology

摘　　要：目的探讨孕早期瘢痕妊娠子宫收缩的MRI诊断与鉴别诊断.方法选取行常规盆腔MRI检查的孕早期瘢痕妊娠患者90例,观察第1个扫描序列矢状位T2 WI抑脂像子宫肌层局灶性低信号的位置、形态等特征,并多方位及隔时扫描后观察其变化.结果79例(87.8%)孕早期瘢痕妊娠子宫肌层有局灶性T2 WI低信号,主要发生于子宫前壁(34例,43.0%)和后壁(28例,35.4%),包括条片状(19例,24.1%)和团块状(60例,75.9%)2种形态,根据信号是否均匀后者分为均匀低信号(38例,63.3%)和以低信号为主的混杂信号(22例,36.7%).多方位观察及隔时扫描矢状位T2 WI抑脂像发现子宫肌层局灶性低信号的形态和/或位置发生改变.结论孕早期瘢痕妊娠子宫肌层局灶性T2 WI低信号是由子宫收缩所致,多方位观察及隔时扫描具有明确诊断与鉴别诊断价值.Objective To explore the diagnosis and differential diagnosis of uterine contraction by using MRI in the first trimester caesarean scar pregnancy(CSP).Methods A total of 90 patients with CSP in the first trimester who underwent routine pelvic MRI examinations were selected to observe the location and morphology of focal hypo-intensity signal in the uterus on the first T2-weighted sagittal fat suppression sequence,and the changes were observed after multi-directional and interval scanning.Results 79(87.8%)patients with CSP in the first trimester showed local T2 WI low signal in the myometrium,which mainly occurred in the anterior wall(34 cases,43.0%)and the posterior wall(28 cases,35.4%),including strip-like(19 cases,24.1%)and mass-like(60 cases,75.9%)forms.According to whether the hypo-signal homogeneity,the latter was divided into homogeneous hypo-intensity signal lesions(38 cases,63.3%)and mixed hypo-intensity signal lesions(22 cases,36.7%).The morphology and/or location of focal hypo-intensity signal in the myometrium were found to be changed by multi-directional observation or a repeat Tz-weighted sagittal fat suppression sequence.Conclusion In first trimester CSP,focal hypo-intensity signal of the myometrium on the first T2-weighted sagittal fat suppression sequence is caused by local contraction of the uterus.The observations of multi-directional and time interval scanning have a definite value in the diagnosis and differential diagnosis.

关 键 词：结合带 子宫收缩 肌瘤 腺肌病 瘢痕妊娠 磁共振成像 

分 类 号：R714.2[医药卫生—妇产科学] R445.2[医药卫生—临床医学]