目的 探讨MRI诊断Herlyn-Werner-Wunderlich综合征(HWWS)的价值.方法 回顾性分析10例经手术及病理证实为HWWS患者的MR平扫及增强扫描特征,并对其进行分型.结果 10例患者中,Ⅰ型4例,Ⅱ型3例,Ⅲ型3例.10例患者均合并斜隔侧肾脏缺如.8例为双子宫、双宫颈,2例为完全纵隔子宫.Ⅰ型阴道斜隔完整,隔后腔和同侧宫腔积血;Ⅱ型阴道斜隔瘘口形成,隔后腔与主阴道腔相通;Ⅲ型阴道斜隔完整,无斜隔侧宫颈壁瘘管形成,隔后腔与主阴道腔相通.10例患者中,8例患者术后预后良好;1例患者术后经期腹痛明显,复查MRI提示右侧卵巢子宫内膜异位囊肿;1例患者术后突发下腹痛,复查MRI提示盆腔炎症.结论 MRI可明确诊断HWWS并对其分型,为临床诊疗提供有价值的信息.%Objective To assess the value of MRI in diagnosis of Herlyn-Werner-Wunderlich syndrome (HWWS).Methods MR images of 10 patients with HWWS confirmed surgically and pathologically were analyzed retrospectively.The classification of HWWS on MRI was discussed.Results The 10 patients were included 4 cases of type Ⅰ,3 cases of type Ⅱ and 3 cases of type Ⅲ.All of them were complicated with ipsilateral renal agenesis.Eight cases were complicated with didelphic uterus and double cervix,2 were complicated with complete septate uterus.Type Ⅰ showed the complete oblique vaginal septum,hematocele in the oblique septum cavity and contralateral uterine cavity.Type Ⅱ showed the oblique septum cavity was connected with main vaginal through the hole of septum.Type Ⅲ showed the oblique septum cavity was connected with main vaginal through the cervical fistula.The prognosis were good in 8 patients.One patient occured obvious dysmenorrhea postoperation and MRI reminded right ovarian endometriosis cyst.One patient occured gusty hypogastralgia,and MRI reminded pelvic inflammation.Conclusion MRI can definitely diagnose and classify HWWS,and can provide useful information in the treatment of HWWS.
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