deSouza N M, Hawley I C, Schwieso J E, Gilderdale D J, Soutter W P
Robert Steiner Magnetic Resonance Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom.
AJR Am J Roentgenol. 1994 Sep;163(3):607-12. doi: 10.2214/ajr.163.3.8079853.
The purpose of this study was to characterize the normal zonal anatomy and vascularity of the cervix on in vivo and in vitro MR images obtained with a receiver coil surrounding the cervix. These appearances provide a normal data base from which to interpret subtle changes in early neoplasia.
Thirteen women of reproductive age with clinically and cytologically normal cervices were imaged with a ring-design solenoid receiver coil that was placed intravaginally and enveloped the cervix. T1- and T2-weighted axial images were obtained. Seven uterine specimens resected for benign disease were similarly studied, and imaging appearances were correlated with histologic findings.
In the in vivo studies, the endocervical mucosa and two stromal zones surrounding the high-signal central canal were identified. Unlike the uterine body, they could be differentiated on both T1- and T2-weighted images, on which the inner ring had a low signal and the outer ring had an intermediate signal intensity. The outer zone was highly vascularized, with inflow effects from large vessels visible on single-slice scans. On administration of gadopentetate dimeglumine, the endocervical mucosa enhanced rapidly, whereas the outer stroma showed more gradual enhancement. The inner zone enhanced slowly relative to the outer zone. The parametrium was visualized up to 6 cm from the center of the coil, and adjacent colon, fat, and blood vessels were identified. Up to four lymph nodes less than 1 cm in diameter were seen in the parametrium of three subjects. In the in vitro studies, the endocervical mucosa was of high signal intensity. In the fibromuscular cervix, an inner low-signal ring correlated with a region of tightly packed stroma (fibroblasts and smooth muscle cells; cell count, 5900 +/- 2376 nuclei/mm2) and the intermediate-signal-intensity outer zone corresponded to a region of more loosely packed stroma (cell count, 2199 +/- 558 nuclei/mm2). Retention cysts were present in two multiparous cervices.
These detailed appearances and enhancement patterns of the normal cervix need to be recognized so that subtle changes in locally invasive cervical neoplasia can be identified.
本研究旨在通过使用环绕宫颈的接收线圈获得的体内和体外磁共振成像（MR）图像，描述宫颈正常的分层解剖结构和血管分布情况。这些表现提供了一个正常数据库，以便解释早期肿瘤形成中的细微变化。
13名宫颈临床及细胞学检查正常的育龄女性，采用置于阴道内并环绕宫颈的环形设计螺线管接收线圈进行成像。获取了T1加权和T2加权轴向图像。对7例因良性疾病切除的子宫标本进行了类似研究，并将成像表现与组织学结果进行了关联。
在体内研究中，识别出宫颈内膜黏膜以及围绕高信号中央管的两个基质区。与子宫体不同，它们在T1加权和T2加权图像上均可区分，内环呈低信号，外环呈中等信号强度。外环血管丰富，在单层扫描中可见来自大血管的流入效应。静脉注射钆喷酸葡胺后，宫颈内膜黏膜迅速强化，而外基质强化较为缓慢。相对于外环，内环强化较慢。子宫旁组织在距线圈中心6厘米范围内可见，且可识别出相邻的结肠、脂肪和血管。3名受试者的子宫旁组织中可见多达4个直径小于1厘米的淋巴结。在体外研究中，宫颈内膜黏膜呈高信号强度。在纤维肌性宫颈中，内部低信号环与紧密排列的基质区域（成纤维细胞和平滑肌细胞；细胞计数为5900±2376个核/mm2）相关，中等信号强度的外环对应于排列较松散的基质区域（细胞计数为2199±558个核/mm2）。两名经产妇的宫颈存在潴留囊肿。
需要认识到正常宫颈的这些详细表现和强化模式，以便能够识别局部浸润性宫颈癌的细微变化。
