MRI对宫角妊娠的诊断价值

MRI in the Diagnosis of Cornual Pregnancy

目的探讨宫角妊娠的MRI特点,评估MRI对宫角妊娠的诊断价值。资料与方法回顾性分析经手术及病理证实的19例宫角妊娠的MRI表现。结果19例患者中,妊娠囊呈单纯囊状13例,混合包块6例;完全位于宫角17例,部分位于宫角并局部凸向宫腔2例;与宫腔相通19例,位于宫角结合带内侧18例,有宫内膜包绕15例,宫内膜蜕膜化13例,宫角胎盘植入8例。患侧宫角扩大19例,宫腔扩大11例。妊娠囊内T1WI呈低信号或伴等信号14例,T2WI呈高及稍高信号16例。妊娠囊边缘T2WI呈条状低信号10例。增强扫描囊内索条状或乳头状强化7例,囊壁不均匀强化8例。结论宫角发现妊娠囊是宫角妊娠最重要的MRI表现。宫角扩大、妊娠囊与宫腔相通、妊娠囊位于结合带内侧、妊娠囊周围宫内膜包绕、宫内膜蜕膜化是诊断宫角妊娠的重要征象。MRI可清晰地显示病灶部位、形态、信号及侵犯周围结构情况,对诊断宫角妊娠有重要价值。

Purpose To investigate the MRI characteristics of cornual pregnancy,and to evaluate the value of MRI in the diagnosis of cornual pregnancy.Materials and Methods MRI features of 19 patients with cornual pregnancy confirmed by operation and pathology were analyzed retrospectively.Results For 19 patients,13 cases showed simple cystic gestational sac,and 6 cases showed mixed mass.The gestational sac was completely located in the uterine horn in 17 cases,partially located in the uterine horn and locally protruded into the uterine cavity in 2 cases.There were 19 cases of communication between the gestational sac and the uterine cavity,18 cases of the gestational sac located in the medial side of the uterine horn junction zone,15 cases of endometrial wrapping of gestational sac,13 cases of the decidualization of the inner membrane,and 8 cases of placenta implantation of the uterine horn.There were 19 cases of angle enlargement and 11 cases of cavity enlargement.There were 14 cases with low or equal signal on T1WI and 16 cases with high or slightly high signal on T2WI.There were 10 cases of strip low signal on T2WI at the edge of gestational sac.There were 7 cases of enhanced intrathecal cord or papillary enhancement and 8 cases of non-uniform enhancement.Conclusion The most important MR manifestation of cornual pregnancy is the finding of gestational sac in cornual pregnancy.The enlargement of the uterine horn,the connection between the gestational sac and the uterine cavity,the location of the gestational sac in the inner side of the junction zone,the wrapping of the endometrium around the gestational sac,and the decidualization of the endometrium are the important signs for the diagnosis of cornual pregnancy.MRI can clearly show the location,shape,signal of the focus and the surrounding structure,which is of great value in the diagnosis of cornual pregnancy.