摘要
目的探讨磁共振成像(MRI)对子宫及下生殖道先天发育异常所致原发性闭经的诊断价值。方法选取2015年11月至2023年5月就诊于首都医科大学附属北京妇产医院因先天发育异常导致原发性闭经的患者41例,回顾性分析其临床表现和MRI影像,总结影像学表现特点。结果结合临床表现和MRI表现,最终诊断先天性子宫阴道缺如(MRKH)综合征27例,雄激素不敏感综合征2例,处女膜闭锁6例,宫颈闭锁2例,阴道下段闭锁4例。27例MRKH综合征患者表现为子宫缺如或始基子宫,伴阴道部分闭锁19例、全程闭锁8例;2例雄激素不敏感综合征患者表现为子宫及宫颈缺如,阴道下段可见,1例性腺位于双侧腹股沟区,1例位于盆腔内髂外血管内侧并伴发肿瘤;6例处女膜闭锁患者表现为子宫腔、宫颈管及阴道全程不同程度积血,1例伴输卵管积血;2例宫颈闭锁患者同时合并阴道闭锁、输卵管积血;4例阴道下段闭锁患者表现为闭锁段上方阴道、宫颈管及宫腔增宽积血。结论MRI可清楚显示子宫及下生殖道发育异常,明确导致原发性闭经的病变部位,为患者下一步诊治提供可靠参考信息。
Objective To explore the MRI features and diagnostic value in the diagnosis of primary amenorrhea caused by uterus and lower genital tract dysplasia.Method A total of 41 patients with primary amenorrhea due to congenital dysplasia admitted to Beijing Obstetrics and Gynecology Hospital,Capital Medical University from November 2015 to May 2023 were selected.Their clinical manifestations and MRI images were retrospectively analyzed,and the imaging features were summarized.Result 41 patients suffered from primary amenorrhea included 27 cases of MRKH syndrome,2 cases of androgen insensitivity syndrome,6 cases of congenital imperforate hymen,2 cases of congenital cervix atresia and 4 cases of lower part vagina atresia.27 cases of MRKH syndrome showed bilateral rudimentary uteri for 24 cases,unilateral rudimentary uteri for 2 cases and totally absent uterus for 1 case.19 cases were involved with partial vaginal atresia,the rest 8 cases manifested complete vaginal atresia.No uterus and cervix were noted in 2 cases of androgen insensitivity syndrome.And inferior vagina was found in the 2 patients.1 case of gonads located in the bilateral inguinal region,and the other medial to the external iliac vessels with accompanying tumors.6 cases of congenital imperforate hymen manifested vaginal,cervical duct and uterine hemorrhage,1 case combined with tubal hemorrhage.2 cases of congenital cervix atresia were accompanied by vaginal atresia and tubal hemorrhage.4 cases of lower part vagina atresia showed dilation of upper part of vagina,cervical duct and uterine.Conclusion MRI can clearly display dysplasia of uterus and lower genital tract,and identify the pathological location,providing reliable reference information for the next diagnosis and treatment of patients.
作者
王新莲
王克杨
赵维敬
梁宇霆
Wang Xinlian;Wang Keyang;Zhao Weijing;Liang Yuting(Department of Radiology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100006,China)
出处
《中国医刊》
CAS
2024年第4期412-416,共5页
Chinese Journal of Medicine
作者简介
通信作者:梁宇霆,E-mail:liangyuting@ccmu.edu.cn。
