【摘要】：目的探討輸卵管積液的CT及MRI影像學(xué)特點,并與病理結(jié)果對照以提高對該病的認識。方法回顧性分析30例輸卵管積液患者的CT、MRI表現(xiàn),觀察、分析病變部位、病灶的形態(tài)及邊界、CT密度及MRI信號、病灶增強后的強化模式等指標。記錄輸卵管積液患者的發(fā)病年齡、合并癥及CT和/或MRI診斷結(jié)果,并進行分組,應(yīng)用χ2檢驗,對漏誤診情況加以分析。結(jié)果雙側(cè)發(fā)病15例,單側(cè)發(fā)病15例,共有45個病灶。22例(73.3%)合并卵巢及子宮其他疾病,其中合并卵巢囊腫12例,子宮肌瘤7例,其他病變6例,同時合并卵巢囊腫及子宮肌瘤3例。附件區(qū)病變在CT及MRI上表現(xiàn)為囊性、囊實性及境界不清晰腫塊分別為36個(80%)、8個(17.8%)、1個(2.2%);病灶外觀呈臘腸樣、單囊、多囊及其他形態(tài)者分別為26個(57.8%)、11個(24.4%)、7個(15.6%)、1個(2.2%)。CT平掃31個病灶多表現(xiàn)為臘腸樣(45.2%)、單囊樣(32.2%)、多囊樣(19.4%)低、略低及等密度腫塊影,邊界清晰,1個(3.2%)病灶呈其他形態(tài);MRI掃描輸卵管積液T1WI呈低信號(86.7%)或等信號(13.3%),T2WI呈高信號(100%),DWI呈低信號(86.7%)或高信號(13.3%);增強掃描除1個病灶未見強化外,其余44個病灶均顯示為囊(管)壁強化,囊(管)內(nèi)液體無強化。45個病灶共漏誤診26個,臘腸樣低密度腫塊者漏誤診率為34.6%,單囊者漏誤診率為81.8%,多囊者漏誤診率為100%,單囊及多囊者的漏誤診率明顯高于臘腸型(χ2=10.65,P0.01)。結(jié)論輸卵管積液好發(fā)于中年女性,合并癥多;其常見的CT及MRI特征為臘腸樣、單囊及多囊樣的水樣密度或信號灶,囊液不強化而囊壁呈薄壁強化。臘腸樣改變易被正確診斷,但單囊、多囊及囊實性者容易漏誤診。
[Abstract]:Objective to investigate the imaging features of fallopian tube effusion by CT and MRI, and to improve the understanding of the disease. Methods the CT,MRI findings of 30 cases of fallopian tube effusion were retrospectively analyzed. The location of lesion, the shape and boundary of the lesion, the CT density and MRI signal, and the enhancement pattern after enhancement were analyzed. The age of onset, complications, CT and / or MRI diagnosis of the patients with fallopian tube effusion were recorded and divided into groups. The misdiagnosis of leakage was analyzed by 蠂 2 test. Results 15 cases were bilateral and 15 cases were unilateral. There were 45 lesions. 22 cases (73.3%) were complicated with ovarian and other diseases, including 12 cases of ovarian cyst, 7 cases of uterine leiomyoma and 6 cases of other diseases. There were 3 cases of ovarian cyst and hysteromyoma at the same time. The lesions in the adnexal region were cystic on CT and MRI, with 36 (80%) solid masses, 8 (17.8%) masses and 1 (2.2%) lesions with a single cyst. There were 26 (57.8%) polycystic lesions, 11 (24.4%) polycystic lesions, 7 (15.6%), 1 (2.2%) plain CT scans, 31 lesions with sausage like (45.2%), single cysts (32.2%), multiple cysts (19.4%), and slightly lower density masses. The boundary was clear, and one (3.2%) lesions showed hypointensity (86.7%) or isointense (13.3%) on T1WI of tubal effusion, and the enhancement scan showed hypointensity (86.7%) or hyperintense (13.3%) on T2WI, and no enhancement was found in 1 lesion. The other 44 lesions showed enhancement of the wall of the capsule (tube), no enhancement of the fluid in the cyst (tube), and 26 misdiagnoses in 45 lesions. The misdiagnosis rate was 34.6% in the patients with low density lumps of sausage, 81.8% in the patients with single cyst and 100% in the patients with polycystic tumors. The misdiagnosis rate of the patients with single cyst and polycystic type was significantly higher than that of the type of sausage (蠂 2 10. 65% P0.01). Conclusion the effusion of fallopian tube is more common in middle aged women than in middle aged women, and the common CT and MRI features are sausage, water density or signal foci of single or polycystic. The cyst fluid is not enhanced and the wall of the capsule is enhanced with thin wall. Dachshund changes are easy to be correctly diagnosed, but single, polycystic and cystic sex patients are prone to misdiagnosis.
【作者單位】： 南京中醫(yī)藥大學(xué)附屬醫(yī)院放射科;南京中醫(yī)藥大學(xué)附屬醫(yī)院病理科;泰山醫(yī)學(xué)院放射學(xué)院;
【分類號】：R711.76;R445.2;R816.91

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