腹壁子宫内膜异位症的MRI表现-MRI features of abdominal wall endometriosis

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【摘要】目的：分析腹壁子宫内膜异位症(AWE)的MRI表现，为临床诊断提供依据。方法：搜集本院经病理证实的9例AWE患者的病例资料，分析MRI平扫及增强扫描影像特征。结果：9例AWE患者中，囊实混合型6例、实质型2例、囊肿型1例。MRI平扫表现：囊实混合型AWE T1WI呈不均匀等低信号，T2WI脂肪抑制序列呈等高混杂信号；实质型AWE T1WI呈不均匀低信号，T2WI脂肪抑制序列呈高、低混杂信号；囊肿型AWE T1WI呈稍低信号，T2WI脂肪抑制序列呈高信号。增强扫描表现：囊肿型的囊变部分无强化，实质性部分有明显强化，肿块病变范围均大于平扫，肿块边缘不规则，与正常组织分界不清。结论：出血、纤维化、钙化等多种混杂信号及增强扫描明显强化是腹壁子宫内膜异位症的特征性表现，结合手术史，腹部切口周围包块伴周期性疼痛有助于确诊。;【Abstract】Objective：To analyze the MRI manifestations of abdominal wall endometriosis (AWE),in order to provide the basis for clinical diagnosis.Methods：The clinical data of 9 patients with pathology proven AWE were collected,and the MRI features before and after contrast enhancement were analyzed.Results：Among 9 patients with AWE,there were mixed cystic-solid type (6 cases),solid type (2 cases) and cystic type (one case).The MRI findings of mixed type AWE were inhomogeneous low signal intensity on T1WI and heterogeneous high signal intensities on T2WI fat suppression sequence;The MRI findings of solid type were inhomogeneous low signal intensity on T1W1 and high or low mixed signal intensities on T2WI fat suppression sequence;The MRI findings of cystic type were slightly low signal intensity on T1WI and high signal intensity on T2WI fat suppression sequence.On enhanced scan the cystic part was not enhanced,the solid part was obviously enhanced,the size of mass was larger than that on plain scan,with ill-defined and irregular margin,which could not be clearly defined with normal tissue.Conclusion：Characteristic manifestations of abdominal wall endometriosis are mixed signal intensities due to hemorrhage,fibrosis,calcification and show obvious enhancement after contrast administration.Accurate clinical diagnosis could be obtained as MRI findings in combination with history of surgery,the mass closed to abdominal incision scar and periodic pain.