宫腔积脓的MRI表现及与病理对照分析

目的 分析宫腔积脓的MRI表现及与病理相关性.方法 回顾性分类总结12例经手术病理证实为宫腔积脓患者的常规MRI、扩散加权成像(DWI)表现特点,计算平均表观扩散系数(ADC)值,并对照分析相对应病理成分.结果 根据积脓MRI信号均匀性分类:信号均匀型2例,T1WI呈稍低信号,T2WI呈稍高信号,DWI呈高信号,脓液中各成分分布较均匀;信号混杂型5例,MRI示脓液底部或周围混杂稍短T2信号,DWI呈混杂高信号,脓液底部见沉淀物;液-液平面型5例,上层呈水样信号,下层T2WI信号较上层低,其中3例下层信号均匀,DWI呈均匀高信号,脓液中各成分分布均匀,2例下层信号混杂,为血性积脓,DWI呈高低混杂信号.12例宫腔积脓平均ADC值为0.532×10-3 mm2/s.12例子宫体积均增大,其中10例子宫壁变薄,另2例子宫壁炎性浸润、增厚;8例患有宫颈癌;5例合并盆腔积液.结论 宫腔积脓的MRI表现具有特征性,其MRI表现与病理成分高度相关,且ADC值在其诊断中具有重要价值.

MRI manifestations of pyometra and comparison with pathologic findings

Objective To discuss the MRI features of pyometra and its correlation with pathologic.Methods MRI and DWI data of 12 cases pyometra proved by surgery and pathology were analyzed retrospectively, and a comparision with pathologic findings was made.Mean ADC values were calculated.Results According to the homogeneity of MRI signal: Uniform signal type in 2 cases,T1WI showed slightly low signal,T2WI showed slightly high signal,DWI showed high signal,and the distribution of pus compositions is relatively uniform;Signal mixed type in 5 cases, T2 showed at the bottom of the pus or peripheral mixed slightly short signal, DWI showed mixed high signal, there was some sediment in the bottom of the pus;5 cases of liquid layer type, the upper displayed signal of water,and the lower signal was lower than the upper signal on T2WI, of which 3 cases showed uniform signal of the lower, DWI showed a uniform high signal, the distribution of pus compositions is uniform, the other 2 cases showed mixed signal of the lower, which was pyometra with bleeding,DWI showed high signal and low signal mixed together.The average ADC value of the 12 patients were 0.532×10-3 mm2/s.12 cases of uterine volume were increased, including 10 cases of uterine wall thinning, the other 2 cases with inflammatory invasion, the uterine wall thickening.8 cases with cervical cancer.5 cases with pelvic effusion.Conclusion MRI findings of pyometra are characteristic, its MRI manifestations and pathological components are highly correlated,and the ADC value is of great value in the diagnosis of pyometra.