目的: 探讨异位妊娠的MRI表现及MRI在诊断中的价值及临床应用。方法: 回顾性分析2013年7月至2017年4月本院收治的,经临床或病理证实的58例不同部位异位妊娠病例的MRI、超声检查结果及临床资料,分别计算MRI与超声的诊断准确率,初步总结其MRI影像特征及临床应用价值。结果: 58例异位妊娠病例,MRI诊断53例,准确率为91.38%,准确率高于超声检查（45例,77.59%）（P<0.05）。56例异位妊娠病例在MRI图像上显示完整孕囊,影像表现为囊性、囊实性或不均质性团块影,孕囊包块MRI图像多表现为圆形或椭圆形,与周围组织分界多较清晰,平扫T1WI呈等、低信号,内夹杂片状、线状略高或高信号,其中高信号与孕囊内出血有关;2例孕囊破裂,影像表现为不规则包块影,T1WI及T2WI信号都不均匀,T1WI呈低、等信号为主,T2WI呈均匀程度不同的高、等混杂信号改变,其内可见散在或斑片状出血信号,T1WI呈高信号,T2WI呈稍高信,孕囊出血及盆腔积血为其特征性表现。结论: MRI检查软组织分辨率高,可全面观察胚囊与周围结构的解剖关系,明确定位,清晰显示孕囊位置及植入情况,对于超声难以确诊的异位妊娠病例可进一步行MRI检查,对病情评估及治疗方案选择有重要参考价值。
Objective: To investigate the manifestation and value of magnetic resonance imaging(MRI) in clinical diag-nosis of ectopic pregnancy(EP). Methods: Ultrasonic and clinical data in 58 cases of ectopic pregnancy confirmed by clini-cal or pathology in our hospital from July 2013 to April 2017 were collected and features of MR imaging were retrospectively analyzed. The diagnostic accuracy of ultrasound and MRI were calculated and compared. Results: Of all the 58 patients, the accuracy rate of MRI in diagnosis of ectopic pregnancy was 91.38%(53 cases), and was higher than that of ultrasound (77.59%, 45 cases)（P<0.05）. MRI could show complete gestational sac and cystic, solid-cystic or heterogeneous mass imaging in 56 cases. The mass of pregnancy sac was round or oval and the boundary with surrounding tissue was clear on MR imaging. The high signal in T1W imaging was related to the hemorrhage of gestational sac. Two cases of ruptured pregnancy sac showed imaging with irregular mass, heterogeneous SI in T1WI and T2WI, and signal of scattered or patchy bleeding was found in the mass, with high SI in T1WI and slightly higher SI in T2WI; imaging of hemorrhage in gestational sac and pelvic hemorrhage were the characteristic features. Conclusions: MRI can clearly reveal the anatomic relationship between embryo sac and its surrounding structures, identifying the location and showing the implantation of gestational sac clearly. For cases of ectopic pregnancy which are difficult to diagnose by ultrasound, MRI examination could be performed, which is of important reference value for evaluation of the disease and selection of treatment options.
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