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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。 Abstract:Objective To explore the characteristics of abdominal wall endometriosis (AWE) on magnetic resonance imaging (MRI). Methods The clinical and MRI data of 7 patients with pathologically confirmed AWE in Peking Union Medical College Hospital from January 2008 to January 2013 were retrospectively collected and analyzed. Results Five of the AWE lesions were single and two were multifocal. Ten AWE lesions were found in 7 patients. Seven out of 10 lesions were located in the left, two in the middle, and one in the right. Five lesions were located in the subcutaneous tissue and fascia, the abdominal muscles were invaded in four lesions, and one was located in the subcutaneous tissue, fascia, and muscle. Endometrial invasion from the scar into the abdominal cavity was observed in two patients, with anterior wall and fundus of the uterus for one patient and anterior wall of bladder for another. Nine lesions were solid and mainly showed isointense or hyperintense signal on T1WI and T2WI compared with muscle with foci of higher intensity on T2WI. In one patient, a cystic hyperintense lesion was found on T1WI (including shading on T2WI). Coexistent abnormality was observed in five patients, including adenomyosis in two, uterine malformation in one, adenomyosis and uterine malformation in one, and fibroid in one patient. Conclusions MRI manifestations of AWE can provide information on the anatomic locations and the lesion extension. Thus, MRI is an important method for preoperative examination and postoperative follow-up. -
Key words:
- abdominal wall endometriosis /
- endometriosis /
- magnetic resonance imaging
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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
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 -
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