剖宫产术后腹壁子宫内膜异位症MRI表现

MRI manifestations of abdominal wall endometriosis after cesarean section

目的观察剖宫产术后腹壁子宫内膜异位症(AWE)MRI表现。方法回顾性分析12例经术后病理证实的剖宫产术后AWE患者。结果12例均为单侧病变,位于剖宫产手术横切口附近;11例形态不规则、边界模糊,1例呈类圆形、边界清晰;11例呈囊实性,1例为囊性病变;囊实性病变T1WI呈不均匀等/低信号、脂肪抑制T2WI为高低不等混杂信号,囊性病变呈较均匀T1WI稍高信号、脂肪抑制T2WI等/稍高信号;增强MRI囊性病变及囊实性病变的囊性成分均未见强化,实性成分见较明显强化,病变范围较平扫增大,边缘不规则,与正常组织界限不清。结论剖宫产术后AWE的MRI表现具有一定特征性,有助于诊断。

Objective To observe MRI manifestations of abdominal wall endometriosis(AWE)after cesarean section.Methods MRI data of 12 cases with AWE after cesarean section confirmed by postoperative pathology were retrospectively analyzed.Results Unilateral lesion located near the transverse incision of cesarean section was detected in all 12 cases,including irregular shape and fuzzy boundary lesions in 11 cases and round lesion with clear boundary in 1 case,11 were cystic-solid and 1 was cystic lesion.The cystic-solid lesions showed uneven isosignal/hyposigna on T1WI,different level mixed signals on fat suppression T2WI,while the cystic lesion showed uniform slightly high signal on T1WI and equal/slightly high signal on fat suppression T2WI.No enhancement of cystic lesion nor cystic components of cystic-solid lesion was found on contrast-enhanced MRI,while the solid components of cystic-solid lesions significantly enhanced,and the lesions became larger than on plain scan,with irregular margins and unclear boundary with normal tissue.Conclusion MRI manifestations of AWE after cesarean section had certain characteristics,contributing to diagnosis of AWE.