子宫腺肌症离体标本的MRI研究

MRI Study of Isolated Specimen of Uterine Adenomyosis

目的 研究离体子宫腺肌症的MRI特征及其组织病理基础 ,为MRI诊断子宫腺肌症提供实验基础。资料与方法 对 16个非子宫体病变、36个子宫腺肌症和 30个子宫平滑肌瘤手术切除的新鲜子宫进行MRI扫描。全部标本均采用TSE序列T1WI、T2 WI及IR序列T1WI,在各序列上观察正常子宫壁MRI结构及子宫腺肌症的MRI特征并与子宫平滑肌瘤比较 ,其结果与组织病理学对照。结果 MRI能显示正常子宫与组织学分层相关的 2～ 4层结构。子宫腺肌症的MRI表现可以体现相关的病理基础 ,病灶表现为结合带弥漫性 /局限性增厚或外肌层结合带样信号灶 ,T2 WI可混杂有局灶性高信号 ;当有陈旧性出血时 ,T1WI也可混杂局灶性高信号灶。子宫有不同程度的增大 ,轮廓光滑 ,有时可见子宫分层结构变形。根据这些特征有助与子宫肌瘤鉴别。结论 子宫腺肌症离体标本具有特征性的MRI征象 ,MRI在子宫腺肌症的诊断和鉴别诊断中有着重要作用。

Objective To study MRI feature of isolated specimen of adenomyosis uteri and its histopathologic basis, to provide experimental evidence for clinical MRI diagnosis.Materials and Methods With turbo spin echo sequence (TSE), including T 1WI and T 2WI, and inversion recovery sequence (IR) T 1WI, MRI scanning was performed on freshly removed uterine specimens of adenomyosis (n=36), leiomyoma (n=30) and lesions of non corpus disease (n=16). The normal uterine wall structure, adenomyosis signs and leiomyoma signs were observed and compared. MRI findings were correlated with histopathologic results.Results On MRI, normal uterus was characterized by 2～4 histologic layers. Adenomyosis displayed signs reflecting the corresponding pathologic changes. The lesion presented as diffuse or localized thickening of the conjugation zone, or as low intensity signal in outer myometrial layer, or mixed with focal high signal on T 2WI. Focal high signal could be also seen on T 1WI when old hemorrhage was present. The uterus was enlarged in different degree with smooth outline, and distorted layered structure was observed in some cases.Conclusion The isolated specimen of uterine adenomysosis has certain characteristic MRI features. MRI is very useful for the diagnosis and differentiation of uterine adenomyosis.