盆腔疾病的MR诊疗讲义.ppt

盆腔疾病的MR诊疗;子宫正常MRI表现;正常 子宫形态（内膜层，结合带，肌层）;平扫T1WI;子宫平滑肌瘤(uterine leiomyoma);子宫平滑肌瘤(uterine leiomyoma);子宫平滑肌瘤(uterine leiomyoma);子宫平滑肌瘤(uterine leiomyoma);病例1:子宫平滑肌瘤;子宫平滑肌瘤(uterine leiomyoma);病例: 女性，39岁，子宫黏膜下平滑肌瘤;病例: 女性，44岁，子宫浆膜下平滑肌瘤（黏液变性）;病例:子宫多发平滑肌瘤;子宫腺肌症(adenomyosis);子宫腺肌症(adenomyosis);病例:女性 ，46岁，子宫腺肌症;;宫颈癌(cervical carcinoma);宫颈癌(cervical carcinoma);宫颈癌病理类型;is the third most common gynecologic malignancy is the most common malignancy in women under 50 years of age 90% of cervical cancers are squamous epithelial carcinomas, with the remainder comprising adenocarcinomas or adenosquamous carcinomas ; 宫颈癌影像学检查的主要作用在于： 观察肿瘤的范围 周围的扩散情况 盆壁有无侵犯以及盆腔有无转移 判断肿瘤分期，为临床提供确定治疗方案的有力依据 ;宫颈癌CT表现;;宫颈癌影像学表现;病例1:女性 ，62岁，子宫颈鳞状细胞癌，II～III级，合并宫腔积液;;病例2:女性 ，38岁，子宫颈鳞状细胞癌，II级;;病例3:女性 ，47岁，子宫颈鳞状细胞癌，II级，侵至深肌层;;病例4:女性 ，59岁，子宫颈鳞状细胞癌，II级，侵犯深肌层;;病例5:女性 ，49岁，子宫颈鳞状细胞癌，合并宫腔积液;女性 ，48岁，子宫颈癌侵犯膀胱;;;病例6: 女性 ，56岁，子宫颈鳞状细胞癌;病例7:女性 ，64岁，子宫颈鳞状细胞癌，II级，侵及浅肌层（大体标本：宫颈管1X0.6X0.5cm息肉样物）;;MR Staging of Cervical Carcinoma;is the most common invasive malignancy of the female genital tract most patients are postmenopausal 65-70% are adenocarcinoma, 15-20% are adenoacanthomas (adenocarcinoma accompanied by benign-appearing squamous cells), 10-15% are adenosquamous carcinomas uterine sarcomas are rare, accounting for only 3-5% of uterine cancers, and comprise either mixed müllerian tumors or leiomyosarcomas ;T1-w: isointense to the uterus unless hemorrhagic areas T2-w: SI intermediate between normal endometrium and normal myometrium MR is often used in evaluating patients with known endometrial cancer, because it is an excellent modality for evaluation of the depth of myometrial invasion, this affects both therapy and prognosis of uterine carcinomas ;Staging of Endometrial Carcinoma;MR Staging of Endometrial Carcinoma;病例:女性，53岁，子宫内膜腺癌，侵及浆膜层;;;卵巢常见的良性病变包括囊肿、囊腺瘤和畸胎瘤，较少见的有Brenner’s瘤、良性卵泡膜细胞瘤、纤维瘤等 卵巢良性病变生长缓慢，早期一般无临床症状，大多数病人因腹部其他不适或体检时偶尔发现，部分病人以腹部肿块为首发症状 如肿瘤有分泌激素功能，可有相应的内分泌症状或月经周期的改变，巨大肿块可出现压迫症状，如排便、排