Tang Xue, Ling Rennan, Gong Jingshan, Mei Dongdong, Luo Yan, Li Minge, Xu Jianmin, Ma Liguo
Department of Radiology, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, Shenzhen 518020, China.
Department of Gynaecology, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, Shenzhen 518020, China.
Quant Imaging Med Surg. 2018 Mar;8(2):187-195. doi: 10.21037/qims.2018.01.10.
In this pictorial review, MR imaging findings of deep infiltrating endometriosis (DIE) are illustrated together with surgical correlation. DIE can appear as irregular nodules or plaques with similar signal intensity to muscle on both T1-weighted and T2-weighted images. Hemorrhage foci and strands or stellate margins are also often noted. Restriction of diffusion can be seen on diffusion-weighted image. Fibrosis and adhesions often result in morphologic changes, such as alimentary tract tortuosity, irregular or nodular thickening of uterosacral ligaments, and partial or complete obliteration of the pouch of Douglas. After intravenous gadolinium contrast agent administration, homo- or heterogeneous mild to moderate enhancement can be observed. MR imaging can depict endometriosis lesions and extension of DIE at different anatomic locations, which is well consistent with surgical findings. Combining signal and morphological abnormalities, MR imaging can diagnose and assess the extension of DIE with high accuracy. MR imaging findings of DIE facilitate surgeons at treatment decision making and patient communication.
在本图片综述中，展示了深部浸润型子宫内膜异位症（DIE）的磁共振成像（MR）表现及其与手术的相关性。DIE在T1加权像和T2加权像上可表现为不规则结节或斑块，信号强度与肌肉相似。常可见出血灶、条索状或星芒状边缘。在扩散加权像上可出现扩散受限。纤维化和粘连常导致形态学改变，如消化道迂曲、子宫骶韧带不规则或结节状增厚以及Douglas陷凹部分或完全闭塞。静脉注射钆对比剂后，可观察到均匀或不均匀的轻度至中度强化。MR成像可显示不同解剖部位的子宫内膜异位症病变及DIE的范围，与手术结果高度一致。结合信号和形态学异常，MR成像能够高度准确地诊断和评估DIE的范围。DIE的MR成像表现有助于外科医生进行治疗决策和与患者沟通。
