2021-PE-산부인과-14번

35세 여자가 연속적으로 3회 자연유산 되어 왔다. 골반 MRI 및 자궁경검사 사진이다. 진단은?<img src="https://bzxuobvwdrvtfqhmvczv.supabase.co/storage/v1/object/public/images/11035">

 35세 여자가 연속적으로 3회 자연유산 되어 왔다. 골반 MRI 및 자궁경검사 사진이다. 진단은?   1. uterine myoma 2. uterine didelphys 3. septate uterus 4. bicornuate uterus 5. Asherman’s syndrome - 해설:  반복적인 유산을 경험한 환자로, Pelvic mri에서 비정상적인 자궁 내강이 확인된다.  두 cavity가 이어지는 부분의 각도가 90도 미만이고, 자궁 내강으로 뻗은 중격의 길이가 1cm이상이며, fundus가 움푹 들어가있지 않은 형태로 septate uterus로 진단할 수 있다.     

쌍각 자궁(bicornuate uterus)은 자궁 바닥이 오목, 중격 자궁(septate uterus)은 자궁 바닥이 볼록하다는 차이가 있습니다.[1]<editable-image src="https://bzxuobvwdrvtfqhmvczv.supabase.co/storage/v1/object/public/images/22056" elements="[{&quot;id&quot;:1,&quot;x1&quot;:381.4713896457766,&quot;y1&quot;:944.7377384196185,&quot;x2&quot;:525.8855585831063,&quot;y2&quot;:661.3589918256131,&quot;type&quot;:&quot;arrow&quot;},{&quot;id&quot;:2,&quot;x1&quot;:716.6212534059946,&quot;y1&quot;:952.9121253405995,&quot;x2&quot;:871.9346049046321,&quot;y2&quot;:683.1573569482289,&quot;type&quot;:&quot;arrow&quot;}]"></editable-image>문제의 경우 자궁 바닥이 볼록하므로 중격 자궁 소견으로 보입니다.<editable-image src="https://bzxuobvwdrvtfqhmvczv.supabase.co/storage/v1/object/public/images/22057" 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<a target="_blank" rel="noopener noreferrer nofollow" href="https://pubs.rsna.org/doi/full/10.1148/rg.2021210022">https://pubs.rsna.org/doi/full/10.1148/rg.2021210022</a>

MRI 상 bicornuate uterus 아닌가요?

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