Kasai M
Department of Obstetrics and Gynecology, Iwate University School of Medicine, Morioka.
Nihon Sanka Fujinka Gakkai Zasshi. 1990 Jul;42(7):711-8.
We investigated the value of MRI in investigating uterine anatomy and disease. 1. Normal uterus: The signal intensity and endometrial thickness changed during the menstrual cycle. Endometrial thickness in the secretory phase was 12.8 +/- 3.6 mm, significantly greater than in the proliferative phase (5.4 +/- 0.7 mm, p less than 0.01). In contrast, endometrial thickness was reduced in postmenopausal women (4.1 +/- 0.9 mm) and was never over 6 mm. 2. Uterine disease: a. T2-weighted images were useful in differentiating leiomyoma and adenomyosis. Leiomyomas appeared as well-circumscribed nodules with sharp margins, while adenomyosis was seen as a low signal intensity area with an irregular border extending beneath the endometrium. b. In endometrial carcinoma, endometrial thickening with a high signal intensity was a characteristic of T2-weighted images, the maximal thickness being 16.5 +/- 6.9 mm. Moreover, endometrial carcinomas invading over 1/3 of the myometrium showed the following features: (1) The ratio of maximal endometrial thickness to uterine cross sectional diameter was over 50%. (2) The minimal myometrial thickness was under 5.0 mm. (3) The minimal to maximal myometrial thickness ratio was under 50%. Furthermore, cervical extension could be detected in all cases of endometrial carcinoma extending to the myometrium in T2-weighted images.
我们研究了磁共振成像(MRI)在子宫解剖结构及疾病检查中的价值。1. 正常子宫:月经周期中,信号强度及子宫内膜厚度会发生变化。分泌期子宫内膜厚度为12.8±3.6毫米,显著大于增殖期(5.4±0.7毫米,p<0.01)。相比之下,绝经后女性子宫内膜厚度减小(4.1±0.9毫米),且从未超过6毫米。2. 子宫疾病:a. T2加权图像有助于鉴别平滑肌瘤和子宫腺肌病。平滑肌瘤表现为边界清晰的结节,边缘锐利,而子宫腺肌病表现为低信号强度区域,边界不规则,延伸至子宫内膜下方。b. 在子宫内膜癌中,T2加权图像的特征是子宫内膜增厚且信号强度高,最大厚度为16.5±6.9毫米。此外,侵犯超过子宫肌层1/3的子宫内膜癌具有以下特征:(1)最大子宫内膜厚度与子宫横径之比超过50%。(2)最小子宫肌层厚度小于5.0毫米。(3)最小与最大子宫肌层厚度之比小于50%。此外,在T2加权图像中,所有侵犯子宫肌层的子宫内膜癌病例均可检测到宫颈受累情况。