摘要
目的探讨女性附件扭转的MRI表现特征。方法回顾性分析26例经手术病理证实的附件扭转患者的影像学资料,均行超声和MRI检查,并与手术结果对照分析。结果本组26例中,输卵管系膜囊肿扭转3例,其中1例继发卵巢蒂扭转;输卵管积水伴扭转1例;原发性卵巢扭转4例,卵巢肿物伴蒂扭转18例。MRI确诊23例,漏误诊3例,诊断准确率约88.5%(23/26),高于同期超声诊断准确率65.4%(17/26)。26例患者的MRI均显示盆腹腔内异常信号肿块,并与一侧宫角或附件相连。2例婴幼儿子宫小、显示不清。扭转蒂呈鸟嘴征12例,结节征或漩涡征12例,结构紊乱2例。漩涡征或鸟嘴征在DWI序列见局部高信号9例(9/10)。增强扫描扭转蒂内见迂曲或漩涡样血管强化7例(7/7)。本组26例中,发生扭转的肿物共27个:囊性肿物16个,囊实性肿物11个。在T2WI及SPIR序列上,囊壁或分隔不规则增厚12例,液-液平面7例,囊实性肿块均为混杂信号。同时合并盆腔积液11例,妊娠4例,子宫肌瘤4例,对侧卵巢畸胎瘤1例,对侧卵巢内膜样囊肿1例,对侧输卵管积水1例。结论女性附件扭转的MRI表现具有特征性,是超声检查的有益补充。
Objective To investigate the features of magnetic resonance imaging （MRI） for adnexal torsion. Methods Total 26 cases of adnexal torsion confirmed by surgery pathology were reviewed retrospectively. All cases received ultra- sonic inspection and MRI scan. And the results were compared with surgical. Results There were mesosalpinx cyst tor- sion （ n = 3 ） , hydrosalpinx torsion （ n = 1 ） , primary ovarian torsion （ n = 4 ） and secondary ovarian mass torsion （ n = 18 ）. MRI diagnosed 23 cases ,missed 3 cases,with an accuracy rate of 88.5% （23/26）. And it was higher than the rate of ul- trasound 65.4% （17/26）. MRI demonstrated abnormal masses in abdominal area in 26 cases. It connected with one side uterine horn and accessories. Two infants could not provide the clear imaging of the uterine. The torsional pedicle presen- ted typical ＂beak sign＂ （ n = 12 ）, ＂whirlpool sign＂ （ n = 12 ） and ＂disordered structure＂ （ n = 2 ）. Beak sign and whirlpool sign exhibited as high signal intensity on diffusion weighted imaging （ DWI ） （ 9/10 ） and like twisted blood vessels en- hancement（7/7）. In 26 cases,there were adnexal torsion（n =27） ： cystic mass（ n = 16） ,solid-cystic mass（n = 11 ）. In T2WI and SPIR, eccentric thickened wall or septa were observed in 12 cases;liquid-liquid levels were observed in 7 ca- ses, the solid-cystic mass showed a mixed signal. It complicated with pelvic effusion （ n = 11 ）, gestation （ n = 4 ）, fibroid （ n =4） ,teratoma of contra-lateral ovary（ n = 1 ） ,chocolate cyst of contra-lateral ovary（ n = 1 ） and the contralateral hydro- salpinx （ n = 1 ）. Conclusion MRI performances of adnexal torsion have certain characteristics. The torsional pedicle can be clearly on MRI. MRI examination is a beneficial supplement to ultrasound.
作者
方必东
王毅
黄群
严志汉
许崇永
FANG Bi-dong WANG Yi HUANG Qun et al(Department of Radiology, the Second Affiliated and Yuying Children＇ s Hospital of Wenzhou Medical University, Wenzhou, Zhefiang 325027, Chin)
出处
《中华全科医学》
2017年第1期135-138,共4页
Chinese Journal of General Practice
基金
浙江省温州市科技局医疗卫生项目(Y20140614)
关键词
卵巢
输卵管
扭转
MRI
Ovarian
Salpinx
Torsion
Magnetic resonance imaging
