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目的探讨子宫内膜异位症(EM)的CT表现及其病理基础,评价CT对EM的诊断价值。方法回顾性分析56例EM的CT表现与临床、手术、病理资料,全组病例均行CT平扫和增强扫描。结果 56例EM的CT检查共发现78个病灶,11个囊实性型,67个囊性型。囊实性型EM的实性部分的CT表现为软组织密度,其病理为大量增生的纤维组织夹杂少量的子宫内膜样组织、含铁血黄素和淋巴细胞、浆细胞;囊性型EM囊壁厚、毛糙,与周围结构粘连,囊液呈高密度或高低混杂密度,囊液分层有液-液平面征。囊壁病理为纤维组织,内衬子宫内膜样组织,囊液为新旧不一的异位内膜经血。结论囊性型EM的CT表现具有一定的特异性。囊实性型EM的CT表现缺乏特异性,但结合临床表现,术前也能做出诊断。
Objective To investigate the CT findings and pathological basis of endometriosis (EM) and evaluate the value of CT in the diagnosis of EM. Methods Retrospective analysis of 56 cases of EM CT findings and clinical, surgical, pathological data, all cases underwent CT scan and enhanced scan. Results 56 cases of EM CT scan found a total of 78 lesions, 11 cystic solid type, 67 cystic types. The cytoplasmic EM of the solid part of the CT showed soft tissue density, the pathological hyperplasia of fibrous tissue mixed with a small amount of endometrial-like tissue, hemosiderin and lymphocytes, plasma cells; cystic type EM capsule wall thickness, Rough, with the surrounding structure of adhesions, cystic fluid was high density or high and low hybrid density, cyst fluid stratified liquid - liquid level sign. Wall of the pathological fibrous tissue, lining the endometrial-like tissue, cyst fluid is old and new different ectopic menstrual blood. Conclusions The cyst type EM has some specific CT features. Solid cyst type CT lack of specificity of CT, but combined with clinical manifestations, preoperative diagnosis can be made.