低场MRI对子宫肌壁间妊娠的诊断应用(附5例报道)  

Application of Low-Field MRI in the Diagnosis of Intramural Pregnancy (Report of 5 Cases)

作　　者：文小检 申光武[2] WEN Xiao-jian;SHEN Guang-wu(Department of Radiology,Hunan Chest Hospital,Changsha 410013,China;Department of Radiology,Hunan Provincial Corps Hospital of CAPF,Changsha 410000,China)

机构地区：[1]湖南省胸科医院放射科,湖南长沙410205 [2]武警湖南总队医院放射科,湖南长沙410006

出　　处：《中国CT和MRI杂志》2023年第2期182-183,共2页Chinese Journal of CT and MRI

摘　　要：目的 探讨子宫肌壁间妊娠的低场MRI表现及诊断价值,为病变早期诊断及定位提供指导。方法 收集本院经手术及病理诊断的5例子宫肌壁间妊娠的临床及MRI资料,分析其MRI影像学特点。结果 5例子宫肌壁间妊娠患者中4例有多次宫腔操作史,1例合并有盆腔软组织粘连。3例病灶位于后壁,1例位于侧壁,1例位于宫角。病灶均呈圆形或类圆形,大小(2.2×1.4×1.4)cm~(2.7×2.7×2.1)cm,病灶内信号不均匀,表现为混杂T_(1)WI低、T_(2)WI等-高信号影,内均可见囊泡状T_(1)WI低、T_(2)WI高信号,2例周围见斑片状T_(1)WI高信号提示出血。病灶主体位于子宫壁内,子宫内膜高信号及联合带低信号连续,子宫肌层中高信号中断,呈膨胀性生长,未突破浆膜层。结论 低场MRI检查能对子宫肌壁间妊娠进行早期诊断及准确定位,对于临床及超声检查难以确诊的病例可进一步行MRI检查。Objective To explore the MRI manifestations and diagnostic value of intramural pregnancy in the uterus,and to provide a basis for the early diagnosis,accurate positioning and selection of treatment options for this type of disease. Methods The clinical data of 5 cases of intramuscular pregnancy diagnosed by surgery and pathology in our hospital were collected,mainly including age,menopause time,relevant laboratory examinations,gynecological history,ultrasound examination and other data. And the MRI imaging data of the lesion(the location of the lesion,size and shape,internal signals,surrounding structures and other manifestations) were observed to analyze the MRI imaging characteristics of the lesion. Results Of the 5 patients with intramural pregnancy,4 cases had a history of multiple uterine cavity operations(Abortion or curettage),and 1 case had pelvic soft tissue adhesions. The lesions in 3 cases were located on the posterior wall,1 case was located on the lateral wall,and 1 case was located on the uterine corner. The lesions were round or quasicircular,with a size of(2.24cm×1.40cm×1.40cm)~(2.72cm×2.70cm×2.13cm). The signal in the lesion was uneven,manifested as mixed signal. And,there were vesicle-like hypo-intensity on T_(1)WI,hyperintensity on T_(2)WI,which were seen in the lesions. The patchy hyper-intensity was seen around the lesion on T_(1)WI in 2 cases,which indicated hemorrhage. The main body of the lesion is located in the uterine wall,the endometrial hyper-intensity and the joint zone are continuous,and the hyper-intensity in the myometrium is interrupted,showing swelling growth without breaking through the serosal layer. Conclusion MRI can provide early diagnosis and accurate positioning of intramural pregnancy.If it is difficult to diagnose by clinical and ultrasound examination,MRI can be further performed to intramural pregnancy.

关 键 词：妊娠 肌壁间 磁共振成像 低场 影像诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]