Wang Y, Lin Q, Sun Z J, Jiang B, Hou B, Lu J J, Zhu L, Feng F, Jin Z Y, Lang J H
Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Fu Chan Ke Za Zhi. 2018 Aug 25;53(8):534-539. doi: 10.3760/cma.j.issn.0529-567x.2018.08.005.
To explore the role of MRI in the pre-operative diagnosis and classification of oblique vaginal septum syndrome (OVSS) . A retrospective analysis of the clinical records and pre-operative MRI images of 19 patients with surgery proved OVSS was carried out. Two experienced radiologists reviewed the pre-operative pelvic MRI of the 19 patients in consensus blind to the surgery results. Characteristics including malformations of the uterus, cervix and vagina, the diagnosis of the disorder and classification were evaluated. Pre-operative MRI diagnosis and classification were correlated with surgical findings. Mean age of onset of symptoms for the 19 patients was 15 years (ranged 9-25 years) , and mean age of menarche was 12 years. Ten patients suffered from dysmenorrhea or lower abdominal pain, 5 patients complained of vaginal discharge, 3 patients had a history of irregular menstruation, 1 patient suffered from primary infertility. All 19 patients showed uteri didelphys. Eighteen patients showed vaginal oblique septum.One patient showed cervical atresia.MRI was completely correlated with the surgery in the pre-operative diagnosis of OVSS. MRI classification was in line with surgery in 17 patients, including 9 patients with imperforate septum (typeⅠ) , 6 patients with perforate septum (type Ⅱ) , 1 patient with imperforate septum and cervical fistula (type Ⅲ) , and another one with cervical agenesis (type Ⅳ) . One case of type Ⅱ was misdiagnosed as type Ⅰ, another one of type Ⅰ was misdiagnosed as type Ⅲ. Pre-operative MRI classification was correlated with surgery in 17 out of 19 patients. Pre-operative MRI allows excellent manifestation and accurate diagnosis of OVSS, and could also facilitate the evaluation of the classification.
探讨磁共振成像(MRI)在阴道斜隔综合征(OVSS)术前诊断及分型中的作用。对19例经手术证实为OVSS患者的临床资料及术前MRI图像进行回顾性分析。两名经验丰富的放射科医生在不知手术结果的情况下,以盲法共同阅片,对19例患者的术前盆腔MRI进行评估,观察子宫、宫颈及阴道的畸形情况,对疾病进行诊断及分型,并将术前MRI诊断及分型与手术结果进行对比。19例患者症状出现的平均年龄为15岁(9 - 25岁),初潮平均年龄为12岁。10例患者有痛经或下腹痛,5例患者有阴道分泌物增多,3例患者有月经不规律史,1例患者有原发性不孕。19例患者均为双子宫,18例患者有阴道斜隔,1例患者有宫颈闭锁。MRI对OVSS的术前诊断与手术结果完全相符。17例患者的MRI分型与手术结果一致,其中9例为无孔斜隔(Ⅰ型),6例为有孔斜隔(Ⅱ型),1例为无孔斜隔合并宫颈瘘(Ⅲ型),另1例为宫颈发育不全(Ⅳ型)。1例Ⅱ型被误诊为Ⅰ型,1例Ⅰ型被误诊为Ⅲ型。19例患者中17例术前MRI分型与手术结果相关。术前MRI对OVSS有良好的显示及准确的诊断能力,还能有助于对其进行分型评估。