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腹壁子宫内膜异位症的磁共振成像表现

梁文华 陆菁菁

梁文华, 陆菁菁. 腹壁子宫内膜异位症的磁共振成像表现[J]. 协和医学杂志, 2014, 5(2): 170-174. doi: 10.3969/j.issn.1674-9081.2014.02.009
引用本文: 梁文华, 陆菁菁. 腹壁子宫内膜异位症的磁共振成像表现[J]. 协和医学杂志, 2014, 5(2): 170-174. doi: 10.3969/j.issn.1674-9081.2014.02.009
Wen-hua LIANG, Jing-jing LU. Magnetic Resonance Imaging Features of Abdominal Wall Endometriosis[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(2): 170-174. doi: 10.3969/j.issn.1674-9081.2014.02.009
Citation: Wen-hua LIANG, Jing-jing LU. Magnetic Resonance Imaging Features of Abdominal Wall Endometriosis[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(2): 170-174. doi: 10.3969/j.issn.1674-9081.2014.02.009

腹壁子宫内膜异位症的磁共振成像表现

doi: 10.3969/j.issn.1674-9081.2014.02.009
详细信息
    通讯作者:

    陆菁菁 电话:010-69157451, E-mail:cjr.lujingjing@vip.163.com

  • 中图分类号: R816.91

Magnetic Resonance Imaging Features of Abdominal Wall Endometriosis

More Information
  • 摘要:   目的  探讨腹壁子宫内膜异位症的磁共振成像(magnetic resonance imaging, MRI)表现特点。  方法  回顾性分析北京协和医院2008年1月至2013年1月经手术病理证实且行MRI检查的7例腹壁子宫内膜异位症患者的临床资料和MRI检查结果。  结果  7例腹壁子宫内膜异位症患者中5例单发, 2例多发; 7例患者共发现病灶10处, 7处病灶位于左侧, 2处位于正中, 1处位于右侧; 5处位于皮下及筋膜、未侵及腹壁肌层, 4处侵及腹壁肌层, 1处累及皮下、筋膜及腹壁肌层; 2处病灶与盆腔内部脏器粘连。10处病灶中, 9处病灶呈实性, T1WI及T2WI上以等信号或稍高信号为主; 1处病灶呈囊性, T1WI呈高信号, T2WI可见"阴影"现象。7例患者有5例合并子宫疾病。  结论  对于腹壁子宫内膜异位症, MRI不但能准确定位, 还能显示病变范围, 是术前检查及术后随访的重要方法。
  • 图  1  38岁女性,腹壁剖宫产切口处瘙痒并发现结节7年, 冠状位T2WI(A)示两个腹壁子宫内膜异位症病灶(箭头),分别位于腹壁切口的左右侧,轴位T1WI(B)及轴位T2WI(C)示病灶(箭头)位于皮下及筋膜,T1WI及T2WI上均可见高信号

    图  2  38岁女性(与图 1所示为同一例患者),腹壁剖宫产切口处瘙痒并发现结节7年, 左侧皮下可见囊状腹壁子宫内膜异位症病灶(箭头),轴位T1WI(A)上呈高信号,轴位T2WI(B)上可见“阴影”现象

    图  3  36岁女性,左下腹痛9个月,伴经期加重2月余, 轴位T1WI(A)示左侧腹壁子宫内膜异位症病灶侵犯腹直肌(箭头),呈等信号,轴位T2WI(B)及矢状位T2WI(C)示左侧腹直肌内可见稍高信号(箭头)

    图  4  35岁女性,经期下腹痛2年, 无泌尿系统症状,轴位T1WI(A)及轴位T2WI(B)上可见左侧腹直肌受侵犯(箭头),该病灶与后方膀胱前壁可见低信号模糊带相连,膀胱内壁光整

    表  1  腹壁子宫内膜异位症患者的临床特点

    患者 年龄
    (岁)
    主诉 既往
    手术史
    既往手术至
    发现包块间
    隔时间(月)
    1 36 左下腹痛9个月,伴经期加重2月余 剖宫产术 29
    2 38 腹壁刀口处瘙痒并发现结节7年 剖宫产术 48
    3 30 发现腹壁包块增大半年 剖宫产术 10
    4 35 发现腹壁切口左上缘包块8年 剖宫产术 1
    5 39 发现腹壁结节伴周期性疼痛14年 剖宫产术 1
    6 39 渐进性经期腹壁切口疼痛3年余 剖宫产术 14
    7 35 经期下腹痛2年 剖宫产术 36
    下载: 导出CSV
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出版历程
  • 收稿日期:  2013-06-12
  • 刊出日期:  2014-04-30

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