女性盆腔囊性病变鉴别诊断中经腹壁超声与MRI的应用价值探讨

目的探究经腹壁超声与MRI在女性盆腔囊性病变鉴别诊断中的应用价值。方法回顾性分析本院2019年1月至2019年6月收治的86例盆腔囊性病变患者的临床资料,患者分别行经腹壁超声与MRI扫描检查,同时获取病例患者术后病理结果,分析经腹壁超声与MRI在女性盆腔囊性病变鉴别诊断中的应用价值。结果盆腔囊性病变者MRI影像学表现:卵巢囊肿,T₁WI低信号、T₂WI高信号,增强扫描后可见壁、分隔及附壁结节强化信号。单纯卵巢囊肿信号均匀、呈圆形或椭圆形,T₂WI水样高信号,T₁WI水样低信号,囊壁薄且光整,无壁结节。盆腔脓肿,呈长T₁、长T₂及压脂成高信号,内壁光滑整齐,无内壁结节;增强扫描后有明显环形强化。子宫平滑肌瘤,T₁WI等低信号、T₂WI低信号,强化程度较正常子宫实质低。腹部超声表现:盆腔脓肿,呈较厚囊壁且包膜完整;卵巢囊肿,为囊性无回声,部分表现为囊壁薄且均匀,亦见囊壁呈乳头状且囊壁增厚,囊肿内部无明显钙化,囊壁乳头状区域存在部分彩色血流信号;子宫平滑肌瘤,低回声、边界清晰,可见少量血流信号。术后病理结果显示卵巢囊肿50例、盆腔脓肿28例、子宫平滑肌瘤8例,而MRI对盆腔囊性病变的整体准确率明显高于经腹壁超声(P<0.05)。结论经腹壁超声与MRI在女性盆腔囊性病变鉴别诊断中均可提供有价值的参考信息,MRI于女性盆腔囊性病变中的诊断优势高于经腹壁超声,但考虑到MRI检测时间长及价格高等限制,临床实践中可根据实际情况合理选择。

Application Value of Transabdominal Ultrasound and MRI in the Differential Diagnosis of Female Pelvic Cystic Lesions

Objective To explore the application value of transabdominal ultrasound and MRI in the differential diagnosis of female pelvic cystic lesions.Methods The clinical data of 86 patients with pelvic cystic lesions who were treated and completed transabdominal ultrasound and MRI examinations in the hospital between January 2019 and June 2019 were retrospectively analyzed.Meanwhile,patients’postoperative pathological results were collected,and the application value of transabdominal ultrasound and MRI in the differential diagnosis of female pelvic cystic lesions was analyzed.Results MRI findings of patients with pelvic cystic lesions were as follows:ovarian cyst,low signal on T₁WI and high signal on T₂WI.Enhancement scan showed enhanced signals of wall,septum and wall nodules.signals of simple ovarian cysts were uniform,round or oval,showing watery high signal on T₂WI,watery low signal on T₁WI,with thin and smooth cyst wall and without wall nodules.Pelvic abscesses showed long T₁,long T₂ and high signal,with smooth and tidy inner walls and without inner wall nodules.There was obvious ring enhancement after enhancement scan.Uterine leiomyoma showed equal and other low signal on T₁WI,low signal on T₂WI and disappearance of normal flow empty signal.Enhancement scan showed vascular occlusion or filling defect.Abdominal ultrasound findings were as follows:pelvic abscesses and cysts showed thicker cyst walls and complete capsules.Ovarian cysts showed no cyst echo,and some showed thin and uniform cyst walls.There also were papillary and thickened cyst walls,no obvious calcification inside the cyst,and color blood flow signals in papillary area of the cyst wall.Uterine leiomyomas showed low echo,clear boundaries,and a small amount of blood flow signals.Postoperative pathological results showed 50 cases of ovarian cysts,28 cases of pelvic abscesses,and 8 cases of uterine leiomyomas.The overall diagnostic accuracy of MRI for pelvic cystic lesions was significantly higher than that of transabdominal ultrasound(P<0.05).Conclusion Both transabdominal ultrasound and MRI can provide valuable reference information in the differential diagnosis of female pelvic cystic lesions.However,MRI has more advantages over transabdominal ultrasound in diagnosis of female pelvic cystic lesions.Considering the long detection time and high cost of MRI,the method can be chosen according to the actual situation in clinical practice.