van Gils A P, Tham R T, Falke T H, Peters A A
Department of Diagnostic Radiology, University Medical Centre Leiden, The Netherlands.
AJR Am J Roentgenol. 1989 Dec;153(6):1235-8. doi: 10.2214/ajr.153.6.1235.
We determined the value of MR for detecting abnormalities of the uterus caused by in utero exposure to diethylstilbestrol in patients in whom such abnormalities were evident on hysterosalpingography. Of 200 women with a history of diethylstilbestrol exposure in utero, 12 had undergone hysterosalpingography as part of an infertility workup. Five of these volunteered to undergo MR imaging of the pelvis. Hysterosalpingography showed abnormalities in all five patients. Abnormalities included hypoplasia of the uterine cavity (3/5), a T-shaped uterine cavity (3/5), constrictions of the uterine cavity (3/5), irregular margins of the uterine cavity (2/5), bilateral hydrosalpinges (2/5), and a diverticulum of a fallopian tube (1/5). MR images showed abnormalities in all five patients. These included hypoplasia of the uterine cavity, uterine corpus, and cervix (3/5); a T-shaped uterine cavity (3/5); constrictions of the uterine cavity (3/5); and bilateral hydrosalpinges (2/5). There was an excellent correlation between the findings on MR images and those on hysterosalpingograms. A thick junctional zone was identified on MR as the cause of constrictions of the uterine cavity seen on hysterosalpingography. MR failed to show the irregular margins of the uterine cavity in two of five cases and a diverticulum of the fallopian tube. We conclude that MR can be used to detect hypoplasia and other congenital abnormalities of the uterus in women with a history of diethylstilbestrol exposure in utero.
我们针对子宫输卵管造影显示子宫存在异常的患者，确定了磁共振成像（MR）在检测子宫内暴露于己烯雌酚所致子宫异常方面的价值。在200名有子宫内己烯雌酚暴露史的女性中，12名作为不孕症检查的一部分接受了子宫输卵管造影。其中5名自愿接受盆腔磁共振成像检查。子宫输卵管造影显示所有5名患者均存在异常。异常情况包括子宫腔发育不全（3/5）、T形子宫腔（3/5）、子宫腔狭窄（3/5）、子宫腔边缘不规则（2/5）、双侧输卵管积水（2/5）以及输卵管憩室（1/5）。磁共振图像显示所有5名患者均存在异常。这些异常包括子宫腔、子宫体和宫颈发育不全（3/5）；T形子宫腔（3/5）；子宫腔狭窄（3/5）；以及双侧输卵管积水（2/5）。磁共振图像与子宫输卵管造影的检查结果之间存在极好的相关性。磁共振成像显示增厚的交界区是子宫输卵管造影所见子宫腔狭窄的原因。磁共振成像在5例中有2例未显示子宫腔边缘不规则以及输卵管憩室。我们得出结论，磁共振成像可用于检测有子宫内己烯雌酚暴露史女性的子宫发育不全及其他先天性异常。
