卵巢肿块蒂扭转的MSCT诊断要点及误诊分析

MSCT diagnostic points and misdiagnosis analysis of ovarian masses tip torsion

目的探讨和分析卵巢肿块蒂扭转的多层螺旋CT(MSCT)影像诊断要点及误诊原因。方法回顾性分析2015年1月至2023年10月在我院经手术病理证实的47例卵巢肿块蒂扭转患者的临床资料。所有患者均进行MSCT检查,对其影像学特征进行总结,并以手术病理结果作为诊断金标准。结果MSCT检查主要影像学表现为42例卵巢肿块患者可见特征性扭转蒂,19例增强患者扭转蒂呈无或轻度强化;47例均出现不同程度囊壁增厚,其中24例伴出血性坏死或梗死;5例卵巢明显增大伴多发小囊样卵泡影;4例患者输卵管过度增粗呈喙状或鸟嘴状突起。经MSCT检查后有5例肿块患者未被明确诊断为蒂扭转。MSCT检查诊断准确率与手术病理结果无显著差异(P>0.05);MSCT检查显示卵巢肿块囊壁厚度结果为(6.37±2.08)mm,与手术病理结果(5.46±1.69)mm比较,差异具有统计学意义(P<0.05)。结论卵巢肿块蒂扭转具有特征性的MSCT影像表现,有助于对此类疾病的早期诊断及鉴别,减少其误诊率,具有较大临床应用价值及意义。

Objective To explore and analyze the main points of multi-slice spiral CT(MSCT)imaging diagnosis of ovarian masses tip torsion and the causes of misdiagnosis.Methods The clinical data of 47 patients with ovarian masses tip torsion confirmed by surgery and pathology in our hospital from January 2015 to October 2023 were retrospectively analyzed.All patients underwent MSCT examination,the imaging features were summarized,and the surgical pathological results were used as the gold standard for diagnosis.Results The main imaging findings of MSCT examination were that 42 patients with ovarian masses showed characteristic tip torsion,and 19 enhanced patients showed no or mild enhancement of tip torsion;all 47 cases had different degrees of cystic wall thickening,of which 24 cases were accompanied by hemorrhagic necrosis or infarction;5 cases of ovarian enlargement with multiple small cystic follicles;4 patients with excessive thickening of the fallopian tubes in the form of beak-like or beak-like protrusions.Five patients with ovarian masses were not clearly diagnosed as tip torsion after MSCT examination.There was no significant difference between the diagnostic accuracy of MSCT and the results of surgical pathology(P>0.05);the results of MSCT examination showed that the thickness of ovarian masses cyst wall was(6.37±2.08)mm,which was significantly different from that of surgical pathology(5.46±1.69)mm(P<0.05).Conclusion The ovarian masses tip torsion has characteristic MSCT imaging findings,which is helpful for the early diagnosis and differential diagnosis of such diseases and reduces the misdiagnosis rate,it has great clinical application value and significance.