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目的提高对双角子宫的核磁共振(MRI)影像表现的认识,了解MRI诊断双角子宫的特点,掌握MRI检查方法的注意事项。方法总结分析7例双角子宫患者的临床表现、影像学检查结果。使用Philips 1.5T核磁共振扫描机扫描,使用腹部线圈,扫描序列为冠状位及轴位T2WI、T1WI及T2WI-SPAIR、矢状位T1WI及T2WI-SPAIR。结果 7例患者中合并子宫肌瘤者2例,其中1例子宫明显增大,合并子宫腺肌症1例,合并双侧卵巢囊肿2例,合并输卵管积水3例,其中左侧输卵管积水2例,右侧输卵管积水1例,1例为产后子宫,左侧腔内胎盘残留。双角子宫MRI表现为平行于宫腔方位图像,子宫底部可见宫底内凹,子宫被分为左右对称的两个子宫体,呈双角状改变,二者共用同一子宫颈;冠状位子宫双角呈分离圆点状改变,T1WI等信号、T2WI高信号。结论 MRI检查能较好显示双角子宫的两个角,能明确诊断,图像清晰、直观易懂,可清楚显示子宫内膜、宫壁及宫外病变,检查无放射性辐射。对于临床疑为子宫畸形的病人,应首选MRI检查。
Objective To improve the understanding of MRI manifestations of the double angle uterus, understand the characteristics of MRI diagnosis of double angle uterus and master the precautions of MRI examination. Methods The clinical manifestations and imaging findings of 7 patients with double angle uterus were analyzed. Scanned using a Philips 1.5T MRI scanner using the abdominal coil with coronal and axial T2WI, T1WI and T2WI-SPAIR, sagittal T1WI and T2WI-SPAIR. Results There were 2 cases of uterine fibroids in 7 cases, including 1 case of uterine enlargement, 1 case of adenomyosis, 2 cases of bilateral ovarian cysts and 3 cases of tubal hydrops, of which the left hydrosalpinx 2 cases, right tubal water in 1 case, 1 case of postpartum uterus, left ventricular placental residue. Dual angle uterus MRI showed parallel to the direction of the uterine cavity image, the bottom of the uterus can be seen concave end of the uterus, the uterus is divided into two symmetrical bilateral uterine body, showing a double angle change, both share the same cervix; coronal uterine double Angle was separated dots change, T1WI and other signals, T2WI high signal. Conclusion MRI examination can better display the two horns of the uterine horn, which can confirm the diagnosis clearly. The images are clear, intuitive and easy to understand. The endometrium, uterine wall and extrauterine lesions can be clearly displayed and no radiation can be detected. For clinical suspected uterine malformations, should be the preferred MRI examination.