卵巢的多层螺旋CT解剖及其临床意义

MSCT Anatomy of ovary and its Clinical Value

目的分析卵巢的多层螺旋CT解剖表现,探讨其在卵巢与非卵巢起源盆部肿块中的鉴别诊断价值。资料与方法回顾性分析20例经临床和B超证实的正常成年女性盆腔以及51例经手术病理证实的盆部肿块的多层螺旋CT表现,盆部肿块中卵巢和非卵巢起源者分别为35例和16例。结果多层螺旋CT能较好地显示卵巢及其与周围组织的解剖关系。通过卵巢静脉追踪至盆腔悬韧带及卵巢窝处,20例正常盆腔中卵巢的识别率为90%(36/40)。卵巢肿块患者中13例较小者见卵巢实质包绕肿块,22例较大者约95%(21/22)见“卵巢静脉征”。8例浆膜下肌瘤中约13%(1/8)见“卵巢静脉征”;另有5例能识别同侧正常卵巢。8例盆部腹膜外肿块均未见“卵巢静脉征”,而且肿块与髂血管、输尿管关系密切,输尿管向内侧移位或直肠向前推移。结论多层螺旋CT可清楚地显示卵巢与周围组织结构的解剖关系,有利于识别正常卵巢以及鉴别卵巢与非卵巢组织起源的盆部肿块。

Objective To analyze the MSCT anatomical images of ovary and investigate its value of differentiating ovarian from non - ovarian origin of pelvic masses. Materials and Methods The MSCT images of 20 normal adult female pelvic proved by clinic and B ultrasound, and 51 pelvic masses proved by surgery and pathology were retrospectively analyzed, including 35 ovarian lesions and 16 non-ovarian masses. Results The MSCT could clearly show anatomy of ovaries and relationship to the adjacent structure. Tracking the ovarian vein to pelvic suspensory ligament and the ovarian fossa, 90% ovaries of normal female were recognized. The 13 smaller ovarian masses were wrapped by normal parenchyma, the sign of ovarian vascular pedicle was identified in 95 % of large ovarian masses and in 13 % of subserosal uterine myoma. The ipsilateral normal ovaries could be recognized in the 5 subserosal uterine myoma. The sign was not identified in all of the 8 extraperitoneal pelvic masses, and masses were closely related to iliac vascular and ureter, and displaced the ureter medially or colon anteriorly. Conclusion The ovary and its anatomical relationship to adjacent structure are reliable depicted with MSCT, which is helpful to differentiating ovarian from non-ovarian origin of pelvic masses.