盆腔脂肪增多症的MRI诊断

Magnetic Resonance Imaging Diagnosis of Pelvic Lipomatosis

目的 总结盆腔脂肪增多症的MRI表现 ,探讨盆腔相关测量的应用价值。方法 12例有完整临床和MRI检查资料的盆腔脂肪增多症病例 ,分析其临床表现、MRI及其他影像学检查结果 ,在矢状面T1WI分别测量膀胱形态指数、膀胱直肠间距、直肠骶椎间距和膀胱精囊角 ,并与正常组 2 0例进行对照。结果 ① 12例均表现为不同程度的盆腔脏器周围脂肪组织增多、膀胱和直肠受压变形、膀胱精囊角增大 ,MRI可多角度显示盆腔脂肪增多和脏器受压的程度。②矢状面T1WI测量盆腔脂肪增多症组的膀胱形态指数、膀胱直肠间距、直肠骶椎间距和膀胱精囊角均显著高于正常对照组 (P <0 .0 5～ 0 .0 1) ;以对照组 x + 3s为阈值 ,膀胱形态指数和膀胱精囊角诊断的敏感性、特异性和阳性预测值均为为 10 0 %。结论 MRI是诊断盆腔脂肪增多症的最佳影像检查方法 ,矢状面T1WI膀胱形态指数和膀胱精囊角的测量对本症的定量诊断最有价值。

Objective To study the MRI features and diagnostic points of pelvic lipomatosis and investigate the value of pelvic measurements. Methods Twelve cases of pelvic lipomatosis with full clinical information were examined with MRI. The results of clinic, MRI and other imaging were analyzed. The shape index of the bladder (BSI), the distance between the bladder and the rectum (BRD), the distance between the rectum and the sacral vertebrae (RSD), the angle between the bladder and seminal vesicle (BSA) were measured on sagittal T1 weighted imaging (T1WI) and compared with those of normal control team. Results ①Overgrowth of normal fatty tissue around the visceral organs of pelvis, deformation and shift of the bladder and rectum, and increasing of BSA were observed in all of 12 cases. MRI could view the grade of overgrowth of normal fatty tissue and the grade of deformation and shift of pelvic organs from different planes. ②Measurement on sagittal T1WI showed that BSI, BRD,RSD, and BSA of pelvic lipomatosis team were all statistically larger than those of control team( P <0.05-0.01). Using the threshold value of 3 standard deviations greater than mean control team values to identify pelvic lipomatosis, the sensitivity, specificity and positive prediction value(PPV) of BSI and BSA were 100% respectively. Conclusion MRI is the most optimal imaging method for diagnosis of pelvic lipomatosis. BSI and BSA on sagittal T1WI are the most useful indexes for qualifying this disease.