MRI在先天性阴道闭锁中的临床应用价值  

Clinical application of MRI for diagnosis of congenital vaginal atresia

作　　者：徐生芳 钱吉芳[1] 朱大林[1] 梁莉 马子涵 易娅闻 陈瑞蓉 彭梅娟[1] XU Sheng-fang;QIAN Ji-fang;ZHU Da-lin(Medical Imaging Center,Gansu Province Maternal and Child Health Care Hosipital,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院医学影像中心,兰州730050

出　　处：《放射学实践》2023年第3期318-321,共4页Radiologic Practice

基　　金：甘肃省卫生健康行业科研计划项目(GSWSKY2021-059)。

摘　　要：目的:探讨术前MRI检查在先天性阴道闭锁中的影像特征以及临床应用价值。方法:回顾性分析经宫腹腔镜、腹腔镜及手术证实的36例先天性阴道闭锁患者的术前临床和影像学资料,依据美国生育学会(AFS)女性生殖道畸形分类系统对阴道闭锁进行分型。将术前MRI与超声结果与术后进行统计学分析。结果:36例先天性阴道闭锁患者中,术前MRI检出率为94.44%(34/36),术前超声检出率为86.11%(31/36),采用Fisher精确概率法,差异无统计学意义(P=0.429)。根据先天性阴道发育异常分类,研究中2例为先天性阴道闭锁Ⅱ型,1例合并宫颈发育不良,1例合并有残角子宫。其他均为Ⅰ型,子宫及宫颈均发育正常。结论:先天性阴道闭锁的发生较为少见,术前需结合临床特征、妇科检查、影像学检查及内分泌和染色体检查等做出诊断,术前准确的影像评估及分型对手术治疗至关重要,MRI可作为术前影像评估的最佳有效检查方法,为临床全面的术前评估和指导手术提供最大的帮助。Objective:To explore the imaging features and clinical value of preoperative MRI for congenital vaginal atresia.Methods:The preoperative imaging and clinical data of 36 patients with congenital vaginal atresia confirmed by uterine laparoscopy,laparoscopy and surgery were retrospectively analyzed.The vaginal atresia was classified according to the American Fertility Society(AFS)classification system of female reproductive tract malformations.MRI and ultrasound features were reviewed according to intraoperative and postoperative results.Results:For 36 cases with congenital vaginal atresia,the detection rate was 94.44%(34/36)and 86.11%(31/36)for MRI and ultrasound,respectively,with no significant difference(P=0.429).Two patients were classified as typeⅡ,1 with cervical dysplasia,and 1 with uterine remnant.The remaining were classified as typeⅠwith normal development of uterine and cervix.Conclusion:Congenital vaginal atresia,as a rare entity,may be confirmed by combining clinical presentation,gynecological physical examination,imaging features,and endocrine and chromosome test.Accurate preoperative imaging evaluation and classification is crucial for surgical treatment,and MRI can be preferred as the optimal method.

关 键 词：先天性阴道闭锁 影像表现 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R711.1[医药卫生—诊断学]