Department of Radiology, Endometriosis Center VUMC, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Eur Radiol. 2010 May;20(5):1267-76. doi: 10.1007/s00330-009-1658-1. Epub 2009 Nov 21.
Abdominal wall endometriosis (AWE) is defined as endometrial tissue that is superficial to the peritoneum. AWE is often difficult to diagnose, mimicking a broad spectrum of diseases. The aim of this study was to describe the appearance of AWE on magnetic resonance (MR) imaging.
We present ten patients with AWE (12 lesions) in which MR imaging was used for diagnosis. MR imaging included T2-weighted imaging and T1-weighted imaging with fat suppression. To assess the value of diffusion-weighted imaging (DWI) in endometriosis, four patients underwent additional DWI. The apparent diffusion coefficient (ADC) was calculated using b values of 50, 400, 800 and 1,200 s/mm(2).
In most cases, the lesion was located ventral or dorsal to the aponeurosis of the rectus oblique muscle (n = 6) or in the rectus abdominis (n = 5). MR of AWE lesions showed isointense or slightly hyperintense signal compared with muscle on T2-weighted images and showed isointense or slightly hyperintense signal compared with muscle on T1-weighted images with foci of high signal intensity, indicative of haemorrhage. The mean ADC value of AWE was 0.93 x 10(-3)/mm(2)/s.
MR imaging seems to be useful in determining the location and depth of infiltration in surrounding tissue preoperatively.
腹壁子宫内膜异位症（AWE）被定义为位于腹膜表面以下的子宫内膜组织。AWE 通常难以诊断，其表现类似于广泛的疾病谱。本研究旨在描述 AWE 在磁共振成像（MR）上的表现。
我们介绍了 10 例 AWE（12 个病灶）患者，这些患者均通过 MR 成像进行诊断。MR 成像包括 T2 加权成像和带脂肪抑制的 T1 加权成像。为了评估扩散加权成像（DWI）在子宫内膜异位症中的价值，4 例患者进行了额外的 DWI。使用 b 值为 50、400、800 和 1200 s/mm2 计算表观扩散系数（ADC）。
在大多数情况下，病变位于腹直肌前鞘的腹侧或背侧（n = 6）或位于腹直肌（n = 5）。AWE 病变的 MR 显示 T2 加权图像上与肌肉等信号或稍高信号，T1 加权图像上与肌肉等信号或稍高信号，伴有高信号强度灶，提示出血。AWE 的平均 ADC 值为 0.93 x 10(-3)/mm(2)/s。
MR 成像似乎可用于术前确定周围组织的位置和浸润深度。
