子宫内膜异位症MR表现.pdfVIP

子宫内膜异位症MR表现 Endometriosis manifests in as many as 10% of women of reproductive age. 10%生育期妇 女有子宫内膜异位症。 The reference standard for the diagnosis of pelvic endometriosis is laparoscopic biopsy of lesions with a suspicious appearance, followed by histologic confirmation. 诊断盆腔子宫内膜异位症主要依据腹腔镜活检。 Three forms of pelvic endometriosis盆腔子宫内膜异位症分类 1. superficial peritoneal lesions, or noninvasive implants 腹膜浅表子宫内膜异位症（非浸润性） They are well recognized at laparoscopy; these have been described as black, white, or red, depending on the degree of fibrosis, scarring, and hemorrhage within the lesion.Small nonhemorrhagic foci of superficial endometriosis are often not detectable with magnetic resonance (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. ovarian endometrioma卵巢子宫内膜异位症 3.deep (or solid infiltrating) pelvic endometriosis盆腔深部（实性浸润性）子宫内膜异位症 It is defined by the invasion of endometrial glands and stroma at least 5 mm beneath the peritoneal surface. It is thought to contribute most often to female pelvic pain and infertility, the two major manifestations. of endometriosis. Infertility is treated surgically (ie, removal of ovarian endometriomas and deep pelvic endometriosis and lysis of adhesions), with medical therapy, and with assisted reproduction techniques. Pain associated with endometriosis is initially treated with antiinflammatory agents and hormonal therapy. Depending on a woman ’s symptoms and desire to preserve fertility, surgical procedures may also be performed. 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。 The findings of an adnexal mass with high signal intensity on T1-weighted MR images and signal intensity lower than that of simple fluid on T2-weighted images helped establish a diagnosis of endometrioma with specificity greater than 90%. In addition to endometrioma, the main differential diagnoses of an adnexal lesion with high signal intensity on T1-weighted images include h