Program in Reproductive and Adult Endocrinology, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892-1109, USA.
J Minim Invasive Gynecol. 2013 Jul-Aug;20(4):533-6. doi: 10.1016/j.jmig.2013.01.012. Epub 2013 Mar 25.
Imaging is often part of the evaluation of gynecologic disorders, with transvaginal ultrasound being the most frequently used imaging modality. Although laparoscopy, hysterosalpingography, and hysteroscopy can add diagnostic accuracy, they are invasive and costly. Magnetic resonance imaging (MRI) has been increasingly used because it is both noninvasive and highly accurate. Although MRI is more expensive than ultrasound, it is less so than surgery. Given the demonstrated accuracy of MRI in assessing müllerian anomalies, additional imaging is not often sought once an MRI diagnosis is made. However, when imaging findings are not pathognomonic via MRI or otherwise, inaccurate diagnoses and their consequences may occur. We describe the case of a 21-year-old woman with unilateral dysmenorrhea whose MRI features suggested a unicornuate uterus with a hematometrous noncommunicating horn although laparoscopy ultimately revealed a necrotic myoma without an accompanying müllerian anomaly.
影像学检查常用于妇科疾病的评估，其中经阴道超声是最常用的影像学检查方法。虽然腹腔镜检查、子宫输卵管造影和宫腔镜检查可以提高诊断准确性，但它们具有侵入性且费用较高。磁共振成像（MRI）的应用日益增多，因为它既无创又高度准确。虽然 MRI 比超声检查更昂贵，但比手术便宜。鉴于 MRI 在评估米勒管畸形方面的准确性已得到证实，一旦做出 MRI 诊断，通常不需要进一步进行影像学检查。然而，当 MRI 或其他检查的影像学结果不具有特征性时，可能会出现不准确的诊断及其后果。我们描述了一例 21 岁单侧痛经患者，其 MRI 特征提示为单角子宫伴积血性非交通性残角，但腹腔镜检查最终显示为无伴随米勒管畸形的坏死肌瘤。
