Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Female External Genitalia and Urethra on MR Imaging: Optimal Pulse Sequence and Comparison of Anatomy in Premenopausal and Postmenopausal Women

여성 외부 생식기와 요도의 자기공명영상 소견: 적합한 영상기법과 폐경 전후의 해부학적 변화 비교

  • Whang, Shin-Young (Department of Radiology, Anam Hospital, College of Medicine, Korea University) ;
  • Ahn, Kyung-Sik (Department of Radiology, Anam Hospital, College of Medicine, Korea University) ;
  • Sung, Deuk-Jae (Department of Radiology, Anam Hospital, College of Medicine, Korea University) ;
  • Park, Beom-Jin (Department of Radiology, Anam Hospital, College of Medicine, Korea University) ;
  • Kim, Min-Ju (Department of Radiology, Anam Hospital, College of Medicine, Korea University) ;
  • Cho, Sung-Bum (Department of Radiology, Anam Hospital, College of Medicine, Korea University) ;
  • Lee, Nam-Joon (Department of Radiology, Anam Hospital, College of Medicine, Korea University)
  • 황신영 (고려대학교 안암병원 영상의학과) ;
  • 안경식 (고려대학교 안암병원 영상의학과) ;
  • 성득제 (고려대학교 안암병원 영상의학과) ;
  • 박범진 (고려대학교 안암병원 영상의학과) ;
  • 김민주 (고려대학교 안암병원 영상의학과) ;
  • 조성범 (고려대학교 안암병원 영상의학과) ;
  • 이남준 (고려대학교 안암병원 영상의학과)
  • Received : 2011.07.05
  • Accepted : 2011.08.04
  • Published : 2011.08.31
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Abstract

Purpose : To describe normal anatomy and compare the differences of external genital organs and urethra on MR imaging in pre- and postmenopausal women. Materials and Methods : A total of 19 pre- and 18 postmenopausal healthy women underwent pelvis MR imaging at 1.5 T. Two radiologists retrospectively scored and compared the image quality of female external genitalia and urethra on axial T2-weighted images (T2WI) and axial fat-suppressed contrast-enhanced T1-weighted images (FSCE-T1WI) by using Wilcoxon signed ranks test. The radiologists compared the wall thickness or size of external genital organs and urethra on FSCE-T1WI between two groups by using Student t test. Results : Image quality was better with FSCE-T1WI than with T2WI in all subjects (p < 0.05). The vestibular bulb, clitoris and labium minor were more clearly visualized on FSCE-T1WI in premenopausal subjects rather than in postmenopausal subjects (p < 0.05). The urethra had a target-like appearance with three layers in premenopausal and postmenopausal subjects. Postmenopausal subjects were observed to have significantly smaller vaginal wall thickness, urethral wall thickness and vestibular bulb width than premenopausal subjects (p < 0.05). Conclusion : The anatomy and morphologic changes of female external genital organs and urethra were well discernible on FSCE-T1WI.

목적 : 자기공명영상에서 여성 외부 생식기의 정상 해부학을 알아보고 폐경 전후의 변화를 비교 분석하고자 하였다. 대상 및 방법 : 골반 자기공명영상을 시행한 총 19명의 폐경 전 여성과 18명의 폐경 후 여성을 대상으로 후향적으로 연구하였다. 두 명의 영상의학과 의사가 독립적으로 T2 강조영상, 지방억제 조영증강 T1 강조영상에서 외부 생식기 해부학 구조물과 요도의 영상의 질을 점수화하여 비교하였다. 폐경 전후의 대상군에서 영상의 질과 외부 생식기 해부학 구조물과 요도의 두께 또는 크기를 지방억제 조영증강 T1 강조영상에서 측정하고 비교하였다. Wilcoxon signed ranks test와 Student t test를 이용하여 통계 분석하였다. 결과 : 여성 외부 생식기의 모든 구조물과 요도의 영상의 질에서 지방억제 조영증강 T1 강조영상 이 T2 강조영상보다 높은 점수를 얻었다 (p < 0.05). 폐경 전 대상군에 비해 폐경 후 대상군에서 질전정구, 음핵 그리고 소음순은 형태적인 명확성이 유의하게 떨어져 보였으나 질과 요도에서 는 의미있는 차이를 보이지는 않았다. 요도는 폐경 전후 여성에서 모두 표적모양의 세 층으로 관찰되었다. 폐경 후 대상군에서 폐경 전 대상군에 비해 질벽의 두께와, 요도벽의 두께, 질전정구의 두께가 감소하였다 (p < 0.05). 결론 : 지방억제 조영증강 T1 강조영상에서 여성 외부 생식기 구조물들과 요도의 정상 해부학과 폐경 전후의 변화를 가장 잘 관찰 할 수 있었다.

Keywords

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