磁共振成像诊断子宫腺肌症的临床价值及准确性分析  

Clinical value and accuracy analysis of magnetic resonance imaging in diagnosis of adenomyosis of uterus

作　　者：李凤国 刘勇[1] Li Fengguo;Liu Yong(Department of Radiology,Affiliated Hospital of Jilin Baicheng Medical College,Baicheng 137000,China)

机构地区：[1]吉林省白城医学高等专科学校附属医院放射科,吉林白城137000

出　　处：《实用妇科内分泌电子杂志》2024年第8期77-79,共3页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的探究磁共振成像(MRI)在子宫腺肌症诊断中的临床优势。方法选取60例疑似子宫腺肌症患者,均在术前进行超声、MRI检查。以手术病理检查结果为金标准,比较两种检查方式的诊断效能以及分析子宫腺肌症的MRI影像学特征。结果60例疑似子宫腺肌症患者中,经手术病理检查确诊,子宫腺肌症43例,阴性17例。MRI检查的诊断特异度、敏感度、准确率均高于超声检查,漏诊率、误诊率均低于超声检查,差异有统计学意义(P<0.05)。43例子宫腺肌症患者中,34例病理诊断为弥漫性子宫腺肌症。经病理检查,诊断为局限性子宫腺肌症9例,其中弥漫性子宫腺肌症在MRI上呈子宫均匀增大,在T2WI上呈弥漫性、均匀/不均匀增厚[平均(20.32±6.38)mm]表现,结合带和内膜以及外肌层无清晰边界,难以和正常肌层区分,10例且存在小囊状高信号。另外,局限性子宫腺肌症MRI影像学图像显示,子宫肌层出现局限性膨大现象,病灶呈不规则/类圆形/卵圆形状,与周边肌层界限不清。结论MRI对子宫腺肌症的早期诊断具有较高的临床价值和准确性,值得临床推广与应用。Objective To explore the advantages of magnetic resonance imaging(MRI)in the diagnosis of uterine adenomyosis.Methods 60 patients suspected of adenomyosis were examined by ultrasound and MRI before operation.With the results of pathological examination as the gold standard,the diagnostic efficacy of the two methods and the MRI imaging features of adenomyosis were compared.Results Of the 60 suspected patients with adenomyosis,43 cases were confirmed by operation and pathological examination,and 17 cases were negative.The diagnostic specificity,sensitivity and accuracy of MRI were higher than those of ultrasound,while the rate of missed diagnosis and misdiagnosis were lower than those of ultrasound,with statistical significance(P<0.05).Of the 43 patients with adenomyosis,34 were pathologically diagnosed as diffuse adenomyosis.By pathological examination,9 cases were diagnosed as localized adenomyosis,of which diffuse adenomyosis showed uniform enlargement of uterus on MRI,and diffuse,uniform/uneven thickening[mean(20.32±6.38)mm]on T2WI.There was no clear boundary between the binding zone,intima and external muscle layer,which was difficult to distinguish from normal muscle layer.There were 10 cases with saccular hypersignal.In addition,MRI images of localized adenomyosis of uterus showed localized enlargement of the myometrium with irregular/quasi-circular/oval shape and unclear boundary with the peripheral myometrium.Conclusion MRI has high clinical value and accuracy in the early diagnosis of adenomyosis of uterus,which is worthy of clinical popularization and application.

关 键 词：子宫腺肌症 磁共振成像 诊断价值 影像学特征 

分 类 号：R445.2[医药卫生—影像医学与核医学] R711.71[医药卫生—诊断学]