磁共振对子宫腺肌病的诊断价值

The value of MRI in the diagnosis of adenomyosis

目的探讨子宫腺肌病的MR影像学表现。方法回顾性分析我院经手术病理证实的26例子宫腺肌病的影像检查资料。结果弥漫型子宫腺肌病15例,MR表现为子宫体积明显增大,子宫内膜结合带弥漫性增厚,在T2WI呈"雪花状"影像特征表现,在T1WI呈等信号。局限型子宫腺肌病11例,MR表现为子宫底或体部局限性增大,在T2WI呈斑点状高信号影,在T1WI呈等信号。增强扫描两者病灶区域强化时间及强化程度均迟于子宫正常肌层,病灶中央囊样出血部位不强化。结论对于临床怀疑子宫腺肌病的患者进行MR检查有肋于与其它内膜病变进行鉴别,更有助于临床医生对本病进行术前评估。

Objective To discuss the MR image features of adenomyosis. Methods MRI findings of 26 cases with surgically and histologically proved adenomyosis were retrospectively analyzed. Results Of all 26 cases, 15 cases were diffuse adenomyosis. All findings of these cases showed enlargement of the uterine body and the junctional zones of uterus were exteusive thickened, which were shown the typical image feature of ＂snowflake sign＂, and appeared as isointensity on T1WI. 11 cases were localized adenomyosis, irregular or round shape lesions were shown in the uterine muscular layer. They appeared as Mottled hyperintensity on T2WI and hypointensity on T1WI. After intravenous injection of Gd-DTPA. The enhanced time and degree of all diffuse and localized adenomyosis were later than the normal myometrium of uterus. The central cystic or hemorrhage lesion was not enhanced. Conclusion The patients suspected of uterus adenomynosis undergoing MR scanning is help to identify with other endometrial lesions. It is also benenfit for the clinician to do preoperative assessment of adenomyosis.