课件：苗勒氏管畸形的影像学诊断北京协和医院.ppt

Imaging of Mullerian Duct Anomalies,北京协和医院 放射科 陆菁菁 M.D.,MDA介绍,Fusion of the Mullerian ducts: the 6th to the 11th weeks of gestation The uterus, fallopian tubes, cervix, and proximal two-thirds of the vagina Not associated with anomalies of the external genitalia or ovarian development 15% women who experience recurrent miscarriages Commonly associated with renal agenesis(30%-50%) Other associated congenital anomalies: vertebral bodies, spina bifida, cardiac, et al,女性生殖管道的发生 中肾管 退化 中肾旁管 输卵管 子宫管 子宫，阴道上部 窦结节 阴道板 空腔化 阴道下部,Ductal development Ductal fusion Septal reabsorption,Prevalence of MDA,5.5% in general population 13-25% among women with recurrent pregnancy loss General population: arcuate uterus, 3.9% Bicornuate uterus, 0.4% Women with infertility or miscarriage: Septate uterus, 15.4%,Imaging Overview,HSG: uterine cavity US, MRI: Greater anatomic detail External uterine contour Concomitant renal anomalies,HSG难以区分子宫纵隔 vs 双角子宫,What is this?,磁共振在女性盆腔应用的优势,无放射性损伤 优于超声: 软组织分辨力高 优于超声: 扫描范围广 优于超声: 磁共振成像图像直观，便于手术大夫理解和参考 超声: 对单角子宫及始基子宫诊断有限度,MRI sequences,Axial T1- and T2- weighted images Oblique coronal T2- weighted images of the uterus 3D T2-weighted Sagittal, T2-weighted,脂肪抑制T2加权横断面图像,T2加权正中矢状面像 （尤其适合子宫走向、宫颈及阴道的观察）,T1加权横断面像,Classification,Agenesis or Hypoplasia,2019/8/4,15,可编辑,Unicornuate Uterus,Unicornuate Uterus,双子宫（Uterus Didelphys）,Uterus Didelphys,Representative line diagram depicting right renal agenesis, uterine didelphys, and vaginal septum,Herlyn-Werner-Wunderlich (HWW) syndrome,Bicornuate Uterus,Septate