Wang S J, Duan N, Hu X Y, Yin Y Y, Guo Y H, Wang Y J, Chen X, Wang Z Q
Department of Radiology, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029,China.
Department of Gynecology and Reproductive Medicine, the Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
Zhonghua Yi Xue Za Zhi. 2021 Sep 21;101(35):2798-2803. doi: 10.3760/cma.j.cn112137-20210714-02749.
To analyze the characteristics of magnetic resonance imaging (MRI) and clinical etiology of ovarian infertility. The data of infertile women who underwent 3.0T MRI and magnetic resonance hysterosalpingography (MR-HSG) examination in the Affiliated Hospital of Nanjing University of Chinese Medicine from September 2017 to March 2020 were collected. The ovarian factors of infertility, as well as the abnormalities of bilateral fallopian tubes and uterus, were evaluated. Etiologies assessed by MRI were finally confirmed by hysteroscopy, laparoscopy, surgery, or a comprehensive clinical diagnosis. Among 1 351 patients, 1 296 cases were eligible and included for further analysis. Evaluated by MRI and MR-HSG, 494(38.12%) cases had ovarian abnormalities, including 239(48.38%) cases of ovarian endometriosiss, 116(23.48%) cases of polycystic ovary syndrome (PCOS), 37(7.49%) cases of diminished ovarian reserve (DOR), 33(6.68%) cases of ovarian mass, 28(5.67%) cases of ovarian injury, and 41(8.30%) cases who had at least two kinds of ovarian diseases. Unilateral and bilateral ovarian abnormalities accounted for 52.02% (257/494) and 47.98%(237/494), respectively.In total, 453 of 494(91.7%) patients had only one kind of ovarian disease. Among the 494 patients, 103(20.85%) cases had abnormal ovary with normal uterus and fallopian tubes, and the other 391(79.15%) cases had abnormalities not only in ovary, but in fallopian tube and/or uterus. Infertility-related ovarian diseases have certain characteristics of MRI findings. 3.0T MRI is useful for comprehensive analysis of etiology in ovarian infertility. Combined with MR-HSG, it provides one-stop assessments of the pelvic factors in female infertility.
分析卵巢性不孕的磁共振成像（MRI）特征及临床病因。收集2017年9月至2020年3月在南京中医药大学附属医院接受3.0T MRI及磁共振子宫输卵管造影（MR-HSG）检查的不孕女性资料。评估不孕的卵巢因素以及双侧输卵管和子宫的异常情况。通过MRI评估的病因最终经宫腔镜检查、腹腔镜检查、手术或综合临床诊断得以确诊。1351例患者中，1296例符合条件并纳入进一步分析。经MRI和MR-HSG评估，494例（38.12%）存在卵巢异常，其中卵巢子宫内膜异位症239例（48.38%）、多囊卵巢综合征（PCOS）116例（23.48%）、卵巢储备功能减退（DOR）37例（7.49%）、卵巢肿物33例（6.68%）、卵巢损伤28例（5.67%）、至少合并两种卵巢疾病41例（8.30%）。单侧和双侧卵巢异常分别占52.02%（257/494）和47.98%（237/494）。494例患者中，453例（91.7%）仅患有一种卵巢疾病。494例患者中，103例（20.85%）卵巢异常但子宫和输卵管正常，另外391例（79.15%）不仅卵巢有异常，输卵管和/或子宫也有异常。不孕相关卵巢疾病具有一定的MRI表现特征。3.0T MRI有助于全面分析卵巢性不孕的病因。结合MR-HSG，可为女性不孕的盆腔因素提供一站式评估。
