子宫内膜异位症MR表现

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1、子宫内膜异位症MR表现Endometriosismanifestsinasmanyas10%ofwomenofreproductiveage.10%生育期妇女有子宫内膜异位症。Thereferencestandardforthediagnosisofpelvicendometriosisislaparoscopicbiopsyoflesionswithasuspiciousappearance,followedbyhistologicconfirmation.诊断盆腔子宫内膜异位症主要依据腹腔镜活检。Threeformsofpelvic

2、endometriosis盆腔子宫内膜异位症分类1.superficialperitoneallesions,ornoninvasiveimplants腹膜浅表子宫内膜异位症（非浸润性）Theyarewellrecognizedatlaparoscopy;thesehavebeendescribedasblack,white,orred,dependingonthedegreeoffibrosis,scarring,andhemorrhagewithinthelesion.Smallnonhemorrhagicfociofsuperfi

3、cialendometriosisareoftennotdetectablewithmagneticresonance(MR)imaging.腹膜浅表病变在腹腔镜下易见，根据成分不同有不同表现（纤维化-黑，瘢痕-白，出血-红）。小的非出血性浅表病变MR显示不清。2.ovarianendometrioma卵巢子宫内膜异位症3.deep(orsolidinfiltrating)pelvicendometriosis盆腔深部（实性浸润性）子宫内膜异位症Itisdefinedbytheinvasionofendometrialglandsand

4、stromaatleast5mmbeneaththeperitonealsurface.Itisthoughttocontributemostoftentofemalepelvicpainandinfertility,thetwomajormanifestations.ofendometriosis.Infertilityistreatedsurgically(ie,removalofovarianendometriomasanddeeppelvicendometriosisandlysisofadhesions),withmedica

5、ltherapy,andwithassistedreproductiontechniques.Painassociatedwithendometriosisisinitiallytreatedwithantiinflammatoryagentsandhormonaltherapy.Dependingonawoman’ssymptomsanddesiretopreservefertility,surgicalproceduresmayalsobeperformed.病变浸润致腹膜下方5mm以下。此型最容易引起盆腔痛及不孕。治疗不孕可进行手

6、术和药物治疗，辅以生殖技术。疼痛可先用抗炎药物或激素治疗，必要时手术治疗。ThefindingsofanadnexalmasswithhighsignalintensityonT1-weightedMRimagesandsignalintensitylowerthanthatofsimplefluidonT2-weightedimageshelpedestablishadiagnosisofendometriomawithspecificitygreaterthan90%.Inadditiontoendometrioma,themain

7、differentialdiagnosesofanadnexallesionwithhighsignalintensityonT1-weightedimagesincludehemorrhagicfunctionalovariancystandmaturecysticteratoma.EndometriomastendedtohavehigherT1andlowerT2signalintensitiesthanhemorrhagiccysts.ThegreaterdegreeofT1andT2shorteninginendometrio

8、masisattributabletotheirhigherproteinconcentrationandviscosity.子宫内膜异位症表现为附件肿块，T1高信号，T2低信号，可双侧，多中心。需与同样T