苗勒氏管畸形的影像学诊断北京协和医院.ppt

ImagingofMullerianDuctAnomalies,北京协和医院放射科陆菁菁M.D.,MDA介绍,FusionoftheMullerianducts:the6thtothe11thweeksofgestationTheuterus,fallopiantubes,cervix,andproximaltwo-thirdsofthevaginaNotassociatedwithanomaliesoftheexternalgenitaliaorovariandevelopment15%womenwhoexperiencerecurrentmiscarriagesCommonlyassociatedwithrenalagenesis(30%-50%)Otherassociatedcongenitalanomalies:vertebralbodies,spinabifida,cardiac,etal,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,DuctaldevelopmentDuctalfusionSeptalreabsorption,PrevalenceofMDA,5.5%ingeneralpopulation13-25%amongwomenwithrecurrentpregnancylossGeneralpopulation:arcuateuterus,3.9%Bicornuateuterus,0.4%Womenwithinfertilityormiscarriage:Septateuterus,15.4%,ImagingOverview,HSG:uterinecavityUS,MRI:GreateranatomicdetailExternaluterinecontourConcomitantrenalanomalies,HSG难以区分子宫纵隔vs双角子宫,Whatisthis?,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,MRIsequences,AxialT1-andT2-weightedimagesObliquecoronalT2-weightedimagesoftheuterus3DT2-weightedSagittal,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,AgenesisorHypoplasia,UnicornuateUterus,UnicornuateUterus,双子宫（UterusDidelphys）,UterusDidelphys,Representativelinediagramdepictingrightrenalagenesis,uterinedidelphys,andvaginalseptum,Herlyn-Werner-Wunderlich(HWW)syndrome,BicornuateUteru