输卵管妊娠的MRI诊断

目的探讨输卵管妊娠的MRI表现特点和诊断价值。方法对临床诊断为异位妊娠的19例患者进行超声和MRI检查,仅1例行MRI增强扫描。17例经手术病理证实为输卵管妊娠,2例经保守治疗证实。结果MRI均明确显示孕囊包块、周围血凝块和游离血性液体。孕囊T1WI以等信号和等高信号多见,T2WI信号复杂。包膜在T2WI和抑脂序列显示清晰,呈低信号。包膜破裂处低信号环消失。1例增强者示孕囊呈多个环状、团块状强化。超声发现孕囊包块14例,2例不确定,3例未见明确孕囊包块。结论输卵管妊娠MRI表现有一定的特点,对超声检查可疑或不确定者,行无创性MRI检查对鉴别诊断和临床诊治有重要作用。

MRI Diagnosis of Tubal Pregnancy

Objective To study the MRI features and diagnostic value of tubal pregnancy. Methods 19 cases who were suspectedclinically ectopic pregnancy were examined by MRI and Ultrasound, only one case underwent contrast-enhanced MRI. 17 cases wereidentified surgically and pathologically. 2 cases were proved by conservative therapy. Results Pregnancy sacs and hemorrhagic clots andfree blood were appeared on MR images. Pregnancy sacs were mainly isointense or isointense combined with hyperintense on T_1WI andcomplicated intense on T_2WI . Pregnancy sac integumentum was hypointense on T_2WI and saturated-fat T_2WI . Hypointense of ruptured integumentum was disappeared. Multicircular and massive enhancement was in only one case on contrast-enhanced MRI T_1WI. Pregnancy sacs (14 cases), suspected (2 cases) and undetected (3 cases) were showed on Ultrasound.Conclusion Tubal pregnancy have theirfeatures and appearances on MRI. It is useful to diagnosis,therapy and differential diagnosis of tubal pregnancy, especially forsuspected and undetected patients on Ultrasound.