子宫腺肌症常见和不常见的MRI表现中英文对照ppt课件

1、usualandunusualimagingmanifestiononmriofadenomyosis，郑州大学第一附属医院磁共振科何杰，2013年4月17日， 子宫腺肌病常见的MRI表现adenomyosisisacommonononeopplasticgynecogigicdiseaseizedbythepresenceneofectopicendoometriumwithinthemometriu y affects multiparous、premenopausalwomenover 30 yearsofageandmaycausedysmenorrhea、menorrhagia、an

2、d abnormal genital bleeding .子宫腺肌病其主要超过30岁，绝经前的产妇可引起月经痛，有月经过多和异常阴道出血的症状。 管理资源(PS ) imainanoninvasivemodality、highsensitivity和specifityfordiagnosisofadenomyosis.incassofanenlargeduterusrevealedwithul tra sonogra ffferentiationofadenomyosisfromleiomyomaorotherpathologicconditionsowingtoitsexcellenttis

3、suecontrastresolution .磁共振(MR )图像是非创伤性的超声波检查发现子宫增大时，磁共振可以以其优异的组织对比度分辨率区分子宫腺肌病和子宫肌瘤及其他疾病。 Introduction，On T2-weighted images， typicaladenomyosisappearsasaill-demarcated low-signal-intensitylesionwithputrineenlargement.however variviosphysiologicorpat rimagingappearanceofadenomyosisandmayresultinatumo

4、rlikeappearance位于T2WI，子宫腺肌病的典型表现为边界不明的低信号强度病变伴有子宫增大。 然而，多种生理和病理变化可影响子宫腺肌病的MRI表现，可引起肿瘤样表现的atypicalmimagingmanifestationofadenomyosis，pitfallsindiagnosisofadenomyosis， 讨论的具体话题有子宫腺肌病典型的MRI表现、子宫腺肌病非典型的MRI表现、子宫腺肌病诊断失误区Introduction、mrimagingmanifestationoftypical adenomyosis、子宫腺肌病典型的MRI表现、typica at pathol

5、ogic analysis adenomyosischaractersizedbythepresecensionofectopicendometrialglandstromawithinthemometriumwithypertr ooth muscleadenomyosismayaffecttheuterinemyometriumdiffuselyandresultinadiffuselyenlargeduterus，oritmaybelocalizedasanadenomy 子宫腺肌病可能会对子宫肌层产生弥漫性的影响，或作为腺肌瘤局限性的影响肌层，acutsectionofadiffuse

6、lyadenomyoticuterushowsthikenedmyometriumdueto thethetchenedmyometriumiscomposedofhaphazardydistribledhyproprothedmustrartrableurrrurrourringectopicendoometrialtissue (fig . brownisholdhemorrhagicfocicorrespondingtohemolysedblood和hemosiderinpigmentdepositsmaybecontainedwithintheareaofadenomyosis 肥厚的

7、肌层由任意分布的肥大性肌小梁和周围子宫内膜组织构成(图1 )。褐色旧出血灶可能对应子宫腺肌病区域内的出血和含有铁蛋白的沉积，Typical Adenomyosis，Fig. 1A 1B，1A，1B，figure1. adenomyosisina 47-year-old woman.47岁photo micrograph (hematoxylin-eosin stain ) showsectopicendoometrialglandsandstroma (arrow ) surroundedbyhypertrohiedsmoothmuscle.a .大致标本的切面照片是弥漫性变厚的子宫肌层b .

8、显微镜下照片(HE染色) 显示异位子宫内膜腺体和间质及周围肥厚的平滑肌，typicaladenomyosisappearsasanall-demarcated low-signal-intensityareaont2- weightedimagesowingtoabunda ation (fig2)“像adenomyoticendometrium一样，whichseldomrespondtohormonalstimuli cyclicchangesincludingdegeneration，bleeding， andredirengarelesscommoninadenomyosisthani

9、nendometriosis .子宫腺肌病的典型表现是T2WI有限的低信号区域，这是由丰富的平滑肌细胞增殖引起的。 腺肌病的子宫内膜和基底子宫内膜一样，对激素的刺激反应很少，因此与其他子宫内膜症相比，变性、出血、 再生这一周期性变化在子宫腺肌病中很少发生，ectopicendometriumappearsassmallhigh-signal-intensityareaslikenormalendometrum (fig2) . smallcystsmayalsoappeonasahigh-signal-intensityspotsont2- weighted images.someth tim

10、es hemorrhagicfociappeonas1-3mm高信号在tedimagesowingtothet1- shortteningeffectsofmethemoglobin (fig2) T2WI图像中，异位子宫内膜显示出与正常子宫内膜同样的小板状高信号，小的囊肿也有可能在t2wi显示出点状高信号。 有时受甲血红蛋白t-1的缩短效果的影响，出血病灶在T1WI为1-3mm的高信号病灶，Typical Adenomyosis， susceptibility-weightedimagingissensitiveforoldhemorrhagicfoci whichiappearasspot

11、tysignalvoidsowingtothet2* - shortingefohemosiderin.at diffusion-weighted imaging adenomyosishaslowtointermediatesignalintensity，afindingconsistithitsbenign nonneoplastic nature (Fig 3)磁敏感加权图像对旧的出血灶敏感，用包含铁蛋白T2缩短效果的图像表现点状低信号。 在分散加权像中，子宫腺肌症显示从低到中程度的信号强度，该表现为良性， 与非肿瘤性病变这一性质一致的mostmalignanttumsheveryhig

12、hsignitionationationsheveryhighsignitioniti afindingthatreflectsthelongt 2 estricteddiffusionduetohighcellularity .但是，DWI上的信号强度和恶性病变之间没有直接相关性的很多恶性肿瘤在DWI上具有非常高的信号强度，这反映了长的T2缓和时间和高细胞密度造成的扩散限制、Typical Adenomyosis、figure2. adenomyosisina 46-year-old woman.46岁女性子宫腺肌病患者(a ) sagitta lt2- weightedfastspin-e

13、chomimageshowsanenlargeduteruswithanill-defined low-signal-intensity lesion (arrow ) intheposteriormyometrium.theresionconsmultiplesmallhigh-signal-intensity areas whichirepresentectopicendoometrialtissueandsma MR图像显示子宫增大，随着一个子宫肌层后壁内边界不清的低信号强度病变(箭头处)，病变含有很多小高信号区域的子宫内膜异位组织和小囊肿(b ) sagitta lt1- weight

14、ed spin-echomrimageshowshigh-signal-intensity spots (arrow ) 代表whicccorresespondsomeofthesmalhigh-signal-intensityareasinonthet2- weighted image.the high-signal-intensityspotsrepresen cendoometrialtissue .矢状位T1加权自旋回波MR图像表示点状高信号，对应于在T2WI中看到的小的高信号区域。 这些点状高信号表示子宫内膜组织内的出血，figure3. adenomyosisina 42-year-old woman.(a ) sagittaldiffusion-weighted echo-planarmrimage (b=800 sec/mm2 showsanenlardgeduteruswithanmil-definedlesionoflowtointermediatesig