摘要
目的 研究MRI在子宫腺肌症诊断中的应用价值。方法 对 30例子宫腺肌症患者行矢状面快速自旋回波 (TurboSE)T1WI、T2 WI、T1和T2 频谱预饱和翻转恢复序列 (T1SPIR和T2 SPIR)扫描 ,必要时辅以横断面或冠状面扫描。所有病例均经手术病理证实。结果 弥漫型子宫腺肌症12例 ,在T2 WI上表现为子宫结合带弥漫性增厚 ,厚度 10～ 35mm ,平均 18mm。 6例病变呈均匀低信号 ;6例病变内有散在的点状高信号区 ,其中 5例在T1WI仍表现为高信号。局限型子宫腺肌症 (腺肌瘤 ) 18例共 2 3个病灶 ,在T2 WI上表现为肌层内卵圆形、不规则形或类圆形肿块 ,呈与结合带信号相近的低信号 ,直径 2 0～ 7 5cm ,平均 3 9cm ,除 1个病灶与周围肌组织有较清楚的界限外 ,其余病灶均与周围肌组织分界不清。 15个病灶内有散在点状高信号区 ,其中 12个在T1WI上也呈高信号。MRI上弥漫增厚的结合带和局限性低信号肿块 ,病理学上为异位内膜岛周围增生肥大的平滑肌 ,其内散在的点状高信号区即异位内膜岛。仅在T2 WI表现高信号的为未出血的内膜岛 ,在T1WI和T2 WI均为高信号的为出血的内膜岛。结论 MRI是诊断子宫腺肌症的优越的无创性检查方法 ,T2 WI为最佳扫描序列 ,T2 WI与T1WI、T1SPIR、T2 SPIR 4种序列相结合可大大提高诊断准确率。
Objective To evaluate the usefulness of MRI in the diagnosis of adenomyosis. Methods Sagittal Turbo SE T 1WI, T 2WI, T 1SPIR and T 2SPIR MRI examination were performed on 30 cases with adenomyosis. Results The lesions in 12 cases with diffuse adenomyosis were demonstrated as diffusely thickened junctional zone (JZ) measured 10～35 mm (mean 18 mm) On T 2WI. 6 of them were of homogenous hypointensity. Another six had hyperintensive foci within the hypointensive lesions on T 2WI, and these hyperintensive foci could also be found on T 1WI in 5 lesions. 23 focal lesions (adenomyomas) in 18 cases were oval, irregular or round masses with hypointensity that were the same as the intensity of JZ on T 2WI. They were from 2.0-7.5 cm in diameter (mean 3.9 cm), and all but one showed ill-defined margins. 15 masses hadhyperintensive foci within the hypointensive lesions on T 2WI and 12 of 15 presented hyperintensity on T 1WI. The diffusely thickened JZ and focal masses correspond to the hyperplastic and hypertrophic musculature around the heterotopic endometrial islands. The hyperintensive foci were correlated with the heterotopic endometrial islands. The hyperintensive foci showed only on T 2WI corresponded to the heterotopic endometrial islands without hemorrhage. The hyperintensive foci shown on both T 2WI and T 1WI were the heterotopic endometrial islands with hemorrhage. Conclusion MRI is the modality of choice for the diagnosis of adenomyosis. T 2WI is the most useful sequence. T 2WI combining with T 1WI, T 1SPIR, and T 2SPIR can improve the accuracy in the diagnosis of adenomyosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2002年第1期67-71,共5页
Chinese Journal of Radiology
