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目的探讨输卵管妊娠的MRI表现特点和诊断价值。方法对临床诊断为异位妊娠的19例患者进行超声和MRI检查,仅1例行MRI增强扫描。17例经手术病理证实为输卵管妊娠,2例经保守治疗证实。结果MRI均明确显示孕囊包块、周围血凝块和游离血性液体。孕囊T1WI以等信号和等高信号多见,T2WI信号复杂。包膜在T2WI和抑脂序列显示清晰,呈低信号。包膜破裂处低信号环消失。1例增强者示孕囊呈多个环状、团块状强化。超声发现孕囊包块14例,2例不确定,3例未见明确孕囊包块。结论输卵管妊娠MRI表现有一定的特点,对超声检查可疑或不确定者,行无创性MRI检查对鉴别诊断和临床诊治有重要作用。
Objective To investigate the MRI features and diagnostic value of tubal pregnancy. Methods Twenty-nine patients with clinically diagnosed ectopic pregnancy underwent ultrasound and MRI examinations, and only one MRI enhanced scan. 17 cases of tubal pregnancy confirmed by pathology, 2 cases confirmed by conservative treatment. Results MRI showed clear gestational sac masses, peripheral blood clots and free bloody fluid. Pregnancy sac T1WI equal signal and contour signals more common, T2WI signal complexity. The envelope showed a clear, low signal on the T2WI and liposomal sequences. Low signal ring disappears at the rupture of the capsule. One case showed enhanced gestational sac multiple rings, lump-like enhancement. 14 cases of gestational sac ultrasound found in 2 cases were indefinite, 3 cases no clear gestational sac mass. Conclusion Tubal pregnancy has certain MRI features. For those with suspicious or uncertain sonographic findings, noninvasive MRI examination plays an important role in differential diagnosis and clinical diagnosis and treatment.