Panageas E, Kier R, McCauley T R, McCarthy S
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06510.
AJR Am J Roentgenol. 1992 Sep;159(3):555-8. doi: 10.2214/ajr.159.3.1503024.
We describe the MR appearance, signs and symptoms, and pathologic findings in five patients with submucosal leiomyomas that prolapsed into the cervical or vaginal canal.
During the past 3 years, five women aged 33-53 years (mean, 43 years) were identified prospectively at MR imaging as having prolapsing uterine leiomyomas. The diagnosis was confirmed by surgical pathology. MR imaging was performed on a 1.5-T unit, using both T1- and T2-weighted spin-echo or fast spin-echo sequences. The images were analyzed for signal intensity, presence of a stalk, and caudal extent of the prolapsed leiomyoma.
These leiomyomas, the presence of prolapse, and the caudal extent of prolapse were detected prospectively on MR images in all five cases. Prospective localization of the stalk in two cases aided subsequent hysteroscopic resection. MR imaging correctly indicated the presence of hemorrhage in one, degeneration in a second, and the absence of these complications in two others. In the fifth case, a hemorrhagic focus in the distal tip of the leiomyoma was not detected on MR images obtained 3 days before surgery.
MR imaging is useful for the diagnosis and characterization of uterine leiomyomas that have prolapsed into the cervical or vaginal canal.
我们描述了五例黏膜下平滑肌瘤脱垂至宫颈管或阴道管患者的磁共振成像（MR）表现、体征和症状以及病理结果。
在过去3年中，前瞻性地通过MR成像确定了5名年龄在33 - 53岁（平均43岁）的女性患有子宫平滑肌瘤脱垂。诊断经手术病理证实。在1.5-T设备上进行MR成像，使用T1加权和T2加权自旋回波或快速自旋回波序列。分析图像的信号强度、蒂的存在情况以及脱垂平滑肌瘤的尾部范围。
在所有五例病例中，通过MR图像前瞻性地检测到了这些平滑肌瘤、脱垂的存在以及脱垂的尾部范围。两例病例中蒂的前瞻性定位有助于随后的宫腔镜切除。MR成像正确显示了一例有出血、一例有退变以及另两例无这些并发症。在第五例中，术前3天获得的MR图像未检测到平滑肌瘤远端尖端的出血灶。
MR成像对于诊断和表征脱垂至宫颈管或阴道管的子宫平滑肌瘤很有用。
