Scoutt L M, McCarthy S M
Department of Diagnostic Imaging, Yale-New Haven Hospital, Connecticut.
Top Magn Reson Imaging. 1990 Jun;2(3):37-49.
The advent of MRI has improved the ability of the diagnostic radiologist to provide useful clinical information to the practicing gynecologist. Although US remains the screening procedure of choice for evaluation of the uterus and adnexa because of its relative safety and low cost, MRI is now considered the next imaging step. In a woman with pelvic pain, MRI can accurately identify adenomyosis, enumerate and localize uterine fibroids, and provide more accurate identification of endometriosis and cystic teratomas of the ovary than US. Although MRI should not be used as a screening procedure for diagnosing endometrial or cervical carcinoma, it can aid in patient management by determining the extent of myometrial or cervical invasion by endometrial carcinoma and can be used to calculate tumor volume in patients with cervical carcinoma. Early studies suggest that MRI may be helpful in distinguishing between long-term radiation fibrosis and tumor recurrence in such patients. MRI findings may be highly indicative of the presence of ovarian malignancy, but the procedure adds little to CT or US findings. Nevertheless, MRI is superior in the localization of pelvic masses and is often indicated in clarifying the origin of a mass as uterine or ovarian.
磁共振成像（MRI）的出现提高了放射诊断医师为妇科执业医师提供有用临床信息的能力。尽管由于超声相对安全且成本较低，仍是评估子宫和附件的首选筛查方法，但MRI现在被视为下一步的成像检查手段。对于有盆腔疼痛的女性，MRI能够准确识别子宫腺肌病，对子宫肌瘤进行计数和定位，并且与超声相比，能更准确地识别子宫内膜异位症和卵巢囊性畸胎瘤。虽然MRI不应作为诊断子宫内膜癌或宫颈癌的筛查方法，但它可以通过确定子宫内膜癌的子宫肌层或宫颈浸润范围来辅助患者管理，还可用于计算宫颈癌患者的肿瘤体积。早期研究表明，MRI可能有助于区分此类患者的长期放射性纤维化和肿瘤复发。MRI表现可能高度提示卵巢恶性肿瘤的存在，但该检查对CT或超声检查结果的补充作用不大。尽管如此，MRI在盆腔肿块的定位方面更具优势，常用于明确肿块起源于子宫还是卵巢。
