子宫腺肌症的MRI诊断及价值

目的:分析子宫腺肌症的MRI表现,探讨其在诊断中的价值。方法:回顾分析本院2011年至2013年55例经病理证实的子宫腺肌症患者的临床及MRI影像资料。结果:55例子宫腺肌症患者的MRI表现:弥漫型34例,T2WI序列均清楚的显示出子宫典型的三层结构,尤其以矢状位显示最佳。34例均有不同程度的宫体增大,结合带均弥漫性的增厚,厚度12⁴8 mm,平均32 mm。其中28例T1WI序列见散在点状高信号灶。DWI序列较轴位T2WI序列均显示出更多更清楚的异常信号结节。局限型21例,在T2WI序列上表现为结合带的局限性增厚并于外肌层内显示边界不清楚的类结合带信号的局限性结节或肿块影。结论:子宫腺肌症在矢状位T2WI序列显示最佳;结合带增厚、与肌层分界不清,并夹杂大小不等类圆形长T1、长T2或短T1信号灶为子宫腺肌症的MRI特征性表现,MRI能够清楚显示这一特征性表现,并对子宫腺肌症的定性、分型、定位、鉴别诊断有着重要价值。

MRI diagnosis and value of uterine adenomyosis

Objective：To analyze the MRI findings and diagnosis value of uterine adenomyosis. Methods：Clinical and MRI data of 55 cases of uterine adenomyosis confirmed by pathology from 2011 to 2013 were retrospectively analyzed. Resuits：MRI findings among the 55 cases of uterine adenomyosis are：34 cases were of diffuse adenomyosis. The typical three-layer structure of Uterine was displayed clearly by sagittal T2WI,especially the sagittal view. All cases showed enlargement of uterus with diffuse thickening. It ranges from 12 mm-48 mm and 34ram on an average. 28 cases showed hyperechoic spots lesions on T1WI. Compared with T2 WI, DWI shows more and clearer abnormal signal nodules. There are 21 circumscribed adenomyosis which displayed localized myometrial masses or nodules at vague margin and widening of junction zone by sagittal T2WI. Conclusion：The uterine adenomyosis are identified clearly by sagittal T2WI. The characteristic visualizations of MRI of uterine adenomyosis are ：widening of junction zone ,vague margin with muscular layer, and quasi-circular long T1 ,T2 and short T1 lesions with different shapes. MRI is also a useful technique for demonstrate the types,size, localization and concurrent changes in adenomyosis,which shows important diagnosis value.