MR动态增强扫描对胚物残留的诊断价值  

Diagnostic value of dynamic contrast-enhanced MR imaging in women with embryo residue

作　　者：关红菲 石丽莉[1] 常利名 GUAN Hongfei;SHI Lili;CHANG Liming(Department of Radiology,Tangshan Maternal and Child Health Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市妇幼保健院,063000 [2]唐山市工人医院

出　　处：《中国煤炭工业医学杂志》2024年第1期28-32,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省卫生健康委员会重点科技研究计划项目(编号:20191537)。

摘　　要：目的探讨盆腔MR动态增强扫描(DCE)对胚物残留的诊断价值。方法收集2018年8月—2022年12月因异常子宫出血就诊、彩超怀疑胚物残留伴血流异常、且行MR盆腔增强检查的108例住院患者临床资料,根据临床治疗方式分为介入栓塞组、弗雷氏球囊压迫止血组,分析二组患者的MR影像学表现。结果108例患者的治疗均有效,无需二次住院。介入栓塞组38例,T2WI肌层可见多发血管流空信号,DCE第2期见迂曲成团明显强化血管,第3期见粗大血管呈持续性强化,增强减影宫腔内见与邻近肌层分界不清的明显强化灶,肌层内见与宫腔病变同步强化的组织,其中3例拒绝术前行介入栓塞,术中出血量多,紧急行介入栓塞。弗雷氏球囊压迫止血组70例,66例肌层见少许血管流空信号,DCE第2~4期可见相对独立的细小强化血管,增强早期部分肌层强化提前,延迟期与正常肌层信号一致;余4例MR表现与介入栓塞组一致,术后球囊宫腔放置3~5d后取出,但2例胚物残留。介入组、弗雷氏球囊压迫止血组间MR主要影像学征象差异有统计学意义(P<0.05)。结论胚物残留患者不同减少出血治疗方式对应的MR影像学表现不同,MR动态增强扫描可为患者精准个体化治疗方案的制定提供可靠依据。Objective To explore diagnostic value of dynamic contrast enhanced pelvic MRI in women with embryo residue.Methods From August 2018 to December 2022,the clinical data of one hundred and eight hospitalized patients with abnormal uterine bleeding,suspected by color Doppler ultrasound of embryo residue with abnormal blood flow,and underwent MR pelvic enhancement examination were collected.According to the clinical treatment,they were divided into interventional embolization group and Freund's balloon compression hemostasis group,and MR imaging manifestations of each group were analyzed.Results The treatment of 108 patients was effective,and there was no need for secondary hospitalization.In interventional embolization group,38 cases showed multiple vascular flow void signals in muscle layer of T2WI,in the second phase of dynamic enhanced scanning sequence,multiple tortuous and obviously enhanced vascular shadows were seen,in the third stage,obvious enhancement of large vascular shadow was seen,showing continuous enhancement.The enhanced subtraction sequence showed that lesions with obvious enhancement were seen in uterine cavity,and boundary with the adjacent muscular layer was unclear.In muscular layer,tissue with synchronous enhancement of uterine cavity lesions can be seen among them.3 patients refused to undergo interventional embolization before operation,there was a lot of bleeding during the operation,emergency interventional embolization.Of the 70 cases in Frey's balloon compression hemostasis group,66 cases showed a small amount of blood vessel flow space signal can be seen in adjacent muscle layer,and the relatively independent enhanced blood vessel shadow can be seen in 2-4 phases of the dynamic enhanced scanning sequence.The enhanced subtraction sequence showed that early enhancement of adjacent myometrium,and the delay period was consistent with normal myometrium signal.MR findings of the remaining 4 patients were consistent with those of the interventional embolization group.Frey's balloon was placed i

关 键 词：子宫 胚物残留 磁共振 动态增强扫描 

分 类 号：R445.1[医药卫生—影像医学与核医学]