Yajima Ryo, Kido Aki, Minamiguchi Sachiko, Moribata Yusaku, Kurata Yasuhisa, Himoto Yuki, Otani Satoshi, Matsumoto Yuka, Horie Akihito, Yamaguchi Ken, Nakamoto Yuji
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Abdom Radiol (NY). 2022 Jun;47(6):1968-1974. doi: 10.1007/s00261-022-03530-4. Epub 2022 May 6.
Polypoid endometriosis is a benign, rare variant of endometriosis that forms polypoid nodules mimicking malignant tumors. For three cases of polypoid endometriosis of female genital organs, this report presents characteristic MR imaging features reflecting the histopathological findings. The solid and microcystic pattern or the multilocular pattern both reflecting dilated endometrial glands, and characteristic morphology of the nodules, multilobulated or polypoid-shaped, were helpful diagnostic clues present in these three cases. Earlier reported MR findings were also recognized, including signal intensity similar to that of the endometrium on T2-weighted image and contrast enhanced T1-weighted image, hypointense rim on T2-weighted image, lack of diffusion restriction, and hyperintense foci on T1-weighted image. Two cases were diagnosed preoperatively based on MR imaging findings as polypoid endometriosis. Fertility-preserving treatment was administered for one patient. Preoperative inference of polypoid endometriosis from MR imaging can avoid overtreatment and lead to fertility preservation.
息肉样子宫内膜异位症是一种良性、罕见的子宫内膜异位症变体,可形成类似恶性肿瘤的息肉样结节。本报告针对三例女性生殖器官息肉样子宫内膜异位症病例,呈现了反映组织病理学结果的特征性磁共振成像(MR)表现。实性和微囊性模式或多房模式均反映了扩张的子宫内膜腺体,以及结节的特征性形态,即多叶状或息肉样,这些是这三例病例中有助于诊断的线索。先前报道的MR表现也得到了确认,包括在T2加权图像和对比增强T1加权图像上与子宫内膜相似的信号强度、T2加权图像上的低信号边缘、无扩散受限以及T1加权图像上的高信号灶。两例病例术前基于MR成像结果诊断为息肉样子宫内膜异位症。对一名患者实施了保留生育功能的治疗。术前通过MR成像推断息肉样子宫内膜异位症可避免过度治疗并实现生育功能保留。