39例腹壁子宫内膜异位症的MRI表现

目的:探讨腹壁子宫内膜异位症的MRI征象及临床特点,探讨MRI的诊断价值.方法:本院39例经病理组织学证实的腹壁子宫内膜异位症患者,经盆腔MRI平扫及增强扫描,回顾性分析其影像表现及临床病理资料.结果:39例腹壁子宫内膜异位症中,大多数患者有剖宫产手术史,仅1例无腹部手术史.34例(87.2％)病灶边界模糊.22例(56.4％)病灶呈实性,T1WI呈等信号,T2WI呈混杂信号为主;15例(38.5％)病灶呈囊实性,T2WI呈高低混杂信号,T1WI以等低信号为主,其中抑脂T1WI中有高信号灶为7例;2例(5.1％)病灶呈囊性,T2WI及T1WI均呈高信号.囊性病灶增强扫描后强化不明显;实性及囊实性病灶增强扫描后病灶均可见持续性强化,病灶显示更加清晰.结论:结合临床病史及MRI表现特点,能准确诊断腹壁子宫内膜异位症,MRI能准确显示病灶位置、边界、大小及范围,对于临床治疗方案的制定有很大参考价值.

MRI appearances of 39 cases with abdominal wall endometriosis

Objective:To study the MRI appearances and clinical features of abdominal wall endometriosis,and to evaluate the diagnostic value of MRI.Methods:Totally there were 39 cases with pathology proven abdominal wall endometriosis,plain and contrast—enhanced MR scanning were performed and the MR images and clinical features were retrospec tively analyzed.Results:Of the 39 cases with abdominal wall endometriosis,38 cases had a history of cesarean section,only one without.34 cases (87.2 ％) had lesion with ill-defined margin,22 cases (56.4 ％) had solid lesion showing iso-intensity on T1WI and heterogeneous intensity on T2WI,15 cases (38.5 ％) had cystic-solid lesion showing mixed intensity on T2WI and mainly hypo-intensity on T1WI,whereas among them,7 cases had hyper-intensity area on fat suppression T1WI,2 cases (5.1％) had cystic component showing hyper-intensity on T1WI as well as T2WI.No enhancement was assessed in cystic lesions after contrast administration,while the solid and cystic-solid cases were found to be enhanced remarkably and con sistently after injection of contrast medium.Conclusion:Abdominal wall endometriosis could be precisely diagnosed by MRI in combination with clinical features.MRI can provide accurate information of the location,margin,size and extension of lesions,which is valuable for treatment planning in clinical practice.