育龄妇女子宫高场强MRI的表现及其周期性改变

High field MRI of uterus and its periodic variation in bearing aged women

目的探讨育龄妇女子宫高场强磁共振成像(MRI)的表现及其随月经周期的变化,为正确诊断子宫疾病提供参考。方法 2014年10月-2017年12月在解放军总医院第六医学中心采用GE3.0T MRI高场强磁共振仪分别于增生期、分泌期对有正常月经周期的30名健康育龄女性志愿者进行高场强MRI检查,以T2加权成像(T2WI)矢状位为主要序列,观察子宫的MRI表现并对两次成像中子宫各带信号、厚度进行比较。结果 T2WI上,子宫由内至外分为高信号内膜层、低信号结合带、中等高信号肌层、低信号浆膜层。子宫各层信号随月经周期而有所变化,分泌期内膜带厚度[(12.2±1.6)mm]明显大于增生期[(5.4±1.2)mm],差异有统计学意义(P<0.01),子宫肌层的T2WI信号值在分泌期(281.3±22.4)明显高于增生期(205.9±19.7),差异有统计学意义(P<0.01)。结论高场强MRI能够精细分辨子宫各层结构,并能评估其周期性改变。

Objective To investigate the high field MRI performance of uterus and its periodical changes in bearing aged women for providing a diagnostic evidence for the uterus diseases.Methods Thirty volunteers with normal menstrual cycle underwent high field-intensity MRI scanning twice within one menstrual cycle(proliferative and secretive phase)with GE3.0T MRI in the Sixth Medical Center of Chinese PLA General Hospital from Oct.2014 to Dec.2017.The sagittal position of T2 weighted images(T2WI)was considered as the main rank to observe the MRI performances of uterus,and the signal intensity and thickness of each part of uterus in the two different phases were measured and compared.Results Uterus demonstrated four layers with different signal intensity on a sagittal T2WI as,from inside to outside,endometrium with high intensity,junction-zone with hypointensity,myometrium with mild hyperintensity,and serosa with hypointensity,respectively.The thickness and the signal intensity in each layer of uterus changed with the menstrual cycle:the thickness of endometrium was thicker in secretive phase than in proliferative phase[(12.2±1.6)mm vs.(5.4±1.2)mm]with significant difference(P<0.01).The T2WI signal intensity of the myometrium was higher in secretive phase than in proliferative phase(281.3±22.4 vs.205.9±19.7)with statistical significance(P<0.01).Conclusion High field MRI may finely discriminate the four layers of uterus and their periodical changes,so can evaluate the lesions of the uterus.