卵巢子宫内膜异位囊肿MRI诊断

MRI diagnosis of ovarian-adenomyosis cyst

目的:通过回顾性分析卵巢子宫内膜异位囊肿患者的病例资料及复习相关文献,提高对卵巢子宫内膜异位囊肿MRI诊断及鉴别诊断水平。方法:分析南京同仁医院2009至2013年55例卵巢子宫内膜异位囊肿的MRI表现,并与腹腔镜手术及病理学检查结果进行对照。结果:55例卵巢子宫内膜异位囊肿患者中24例为单发,31例为多发;共检出97个异位囊肿病灶。其中T1WI、T2WI呈均匀高信号44个;T1WI呈高信号,T2WI呈"阴影"样信号24个;T1WI呈高信号,T2WI呈低信号的16个;T1WI呈混杂信号,T2WI呈低信号2个。11个囊肿内信号出现分层,26个囊内有分隔,20个囊内见含铁血黄素沉着;囊肿边缘均见纤维包膜低信号,其中21个边缘见"卫星囊",4个"囊壁缺口征"。腹腔镜下证实:13例患者卵巢边缘光滑,42例卵巢与周围组织、器官不同程度粘连;另发现10例卵巢外内膜异位病灶。结论:MRI在卵巢子宫内膜异位囊肿定位、定性诊断上具有较高的准确性。MRI所表现的囊肿内信号变化、囊肿边缘特征性改变以及周围粘连情况为内膜异位囊肿的诊断及术前评估提供了可靠的依据。

Objective： To improve the level of the MRI diagnosis and differential diagnosis about ovarianadenomyosis cyst through the retrospective analysis of ovarian-adenomyosis cyst cases and the review of the related literature. Methods： MRI characteristic findings of ovarian-adenomyosis cyst in 55 patients were analyzed, and were juxtaposed with the laparoscopic surgery and pathological diagnosis during 2009 to 2013 year in Nanjing Tongren Hospital hospital. Results： Twenty-four cases from 55 patients were solitary cysts and 31 multiple cysts. Ninety- seven cysts were detected in the patients. Of which, 44 lesions showed the hyperintense on T1WI and T2WI, 24 lesions showed the hyperintense on T1WI and the ＂shadow＂ signal on T2WI, 16 lesions showed the hyperintense on T1 WI and the hypointense on T2W1,2 lesions showed the mixed density on T1 WI and the hypointense on T2WI, 11 lesions showed the hierarchical signal in cysts,26 lesions with septum,20 lesions with hemosiderosis, and all of them were fibrous-capsule hypointense on border. There were 21 stellate-cysts on border,and 4 capsule wall gap. The ovary border of 13 patients were proved smooth, and 42 patients were adhered to surrounding tissue and organs on laparoscopy diagnosis,Moreover the extraovarian endometriosis were found in 10 cases. Conclusion： MRI has high accuracy in the locating,the qualitative. The signal variation of the cyst,the characteristic of the cyst border and the adhesion with sround on MRI provided a basis for diagnosis and preoperative evaluation of ovarian-adenomyosis cyst.