子宫腺肌症临床与诊断分析

Clinical and Diagnosis Analysis of Uterine Adenomyosis Disease

目的探讨子宫腺肌症临床及影像学表现特征。方法回顾性分析2015年1月—2016年12月该院收治并经手术切除及病理证实的96例子宫腺肌症的临床及影像学资料。全部病例均有彩超资料,8例同时有MRI资料。重点分析其临床、影像学表现及分型。结果患者多以慢性盆腔疼痛(n=91)、痛经(n=86)、月经过多(n=80)、不孕(n=6)就医。96例彩超提示弥漫型78例,表现为子宫弥漫性较均匀增大,多无包膜,界限欠清,呈粗粒状、点状或网格状强弱不等回声且以弱回声多见;局限型18例,主要表现为子宫后壁增大。彩色多普勒血流显像(CDFI)均可见病灶内部血流较周边丰富。8例MRI中弥漫型5例,MRI可见子宫较弥漫性增大,结合带增厚;局灶型3例,MRI主要表现为子宫后壁局限性增大,相应结合带增厚且界限欠清。MRI上病灶内见T1WI等T2WI稍低信号,伴多发混杂点状高信号,呈"雪花样"改变。结论子宫腺肌症具有一定的临床特征,彩超和MRI尤其是MRI可较好观察子宫腺肌症的影像学特征,值得应用。

Objective To study the clinical and imaging features of uterine adenomyosis diseases. Methods 96 cases of patients with uterine adenomyosis diseases proved by pathology admitted and treated in our hospital from January 2015 to December 2016 were selected and all patients had the color ultrasound data, and 8 cases had the MRI data at the same time,and the clinical, imaging manifestations and typing were especially analyzed. Results The patient were treated due to chronic pelvic pain（n=91）, dysmenorrhea（n=86）, menorrhagia（n=80）, and infertility（n=6）, and the color ultrasound of 96 cases reminded that there were 78 diffuse type cases, and the manifestations were uterus diffuse homogeneous enlargement,majority without coating, unclear limit, showing coarse, dotted and net shapes and weak echo in common, 18 cases were limited, and the main manifestations were increased posterior uterine wall, and the CDFI was seen that the blood flow in lesions was richer than peripheral blood flow, and of 8 cases with MRI, there were 5 diffuse cases, and the MRI showed that the uterus were diffuse enlargement and increased thickness, and 3 focal type cases, and the main manifestations of MRI were the increased limitation of posterior uterine wall and also increased thickness and the limit was unclear, and the MRI showed that the T1 WI, T2 WI low signals in lesion with multiple, mixed and dotted high signals, showing the snowflake-like changes. Conclusion Uterine adenomyosis disease has a certain clinical features, and the color ultrasound and MRI, especially MRI can better observe the imaging features of uterine adenomyosis disease, which is worth application.