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原发性闭经患者中迈耶-罗基坦斯基-库斯特-豪泽综合征(MRKH)的MRI表现谱

Spectrum of MRI Appearance of Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome in Primary Amenorrhea Patients.

作者信息

Boruah Deb Kumar, Sanyal Shantiranjan, Gogoi Bidyut Bikash, Mahanta Kangkana, Prakash Arjun, Augustine Antony, Achar Sashidhar, Baishya Hiranya

机构信息

Assistant Professor, Department of Radiodiagnosis, Assam Medical College, Dibrugarh, Assam, India.

Consultant Radiologist, Department of Radiodiagnosis, Airedale General Hospital, Keighley, West Yorkshire, United kingdom.

出版信息

J Clin Diagn Res. 2017 Jul;11(7):TC30-TC35. doi: 10.7860/JCDR/2017/29016.10317. Epub 2017 Jul 1.

Abstract

INTRODUCTION

Mayer-Rokitansky-Kuster-Hauser (MRKH) synd-rome is a malformation in female genital tract due to interrupted embryonic development of para-mesonephric ducts leading to uterine and proximal vagina aplasia or hypoplasia.

AIM

To analyse the MRI findings in females suspected of MRKH syndrome in a primary amenorrhea workup.

MATERIALS AND METHODS

A cross-sectional study comprising of 11 patients of MRKH syndrome presented in a tertiary care centre from March 2016 to February 2017 evaluated in 1.5 Tesla MRI scanner.

RESULTS

Normal positioned small vestigial uterus demonstrated in two patients (18.2%) and complete uterine and proximal vaginal agenesis were noted in nine patients (81.8%). The mean volume of rudimentary right uterine bud was 2.26 mL ±3.3 (SD) and left uterine bud was 1.27 mL±1.1 (SD). The mean volume of right ovary was 4.74 mL±2.58 (SD) and left ovary was 4.65 mL±2.2 (SD). The mean developed vaginal length was 26.2 mm±6.34 (SD).

CONCLUSION

The rudimentary uterine buds associated with MRKH syndrome always maintained caudal relationship with ovary. Ovaries or rudimentary uterine buds can be ectopic and should be recognized with MRI before undergoing fertility treatment. Following MRI diagnosis, surgery allows patients to have sexual function with possible attainment of reproduction after assisted reproduction technique or surrogacy.

摘要

引言

迈耶-罗基坦斯基-库斯特-豪泽(MRKH)综合征是一种女性生殖道畸形,由于副中肾管胚胎发育中断,导致子宫和近端阴道发育不全或发育不良。

目的

分析疑似MRKH综合征的女性在原发性闭经检查中的MRI表现。

材料与方法

一项横断面研究,纳入了2016年3月至2017年2月在一家三级医疗中心就诊的11例MRKH综合征患者,在1.5特斯拉MRI扫描仪上进行评估。

结果

两名患者(18.2%)显示子宫位置正常但发育不全,九名患者(81.8%)出现子宫和近端阴道完全缺如。右侧残角子宫芽的平均体积为2.26 mL±3.3(标准差),左侧子宫芽为1.27 mL±1.1(标准差)。右侧卵巢的平均体积为4.74 mL±2.58(标准差),左侧卵巢为4.65 mL±2.2(标准差)。已发育阴道的平均长度为26.2 mm±6.34(标准差)。

结论

与MRKH综合征相关的残角子宫芽总是与卵巢保持尾侧关系。卵巢或残角子宫芽可能异位,在接受生育治疗前应通过MRI识别。MRI诊断后,手术可使患者具备性功能,并有可能在辅助生殖技术或代孕后实现生育。

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