卵巢囊性病变蒂扭转伴出血性梗死的MSCT表现:7例误诊分析

MSCT manifestations of ovarian cystic lesion with torsion and hemorrhagic infarction:review of 7 misdiagnosed cases

目的:探讨卵巢囊性病变蒂扭转伴出血性梗死的MSCT表现。方法:回顾性分析7例术前误诊,经手术病理证实的卵巢囊性病变蒂扭转伴出血性梗死的临床资料和MSCT,总结其CT特征。结果:7例均表现为囊性、实性双肿块。囊壁明显增厚,密度增高6例,增强无强化5例,轻度强化1例;囊内出血呈液液平1例。实性肿块即扭转蒂部为不规则团块状1例,绳索状及发髻状各3例,平扫均呈高密度,增强后无强化5例及轻度强化2例。7例双肿块的实性肿块均偏向扭转侧。结论:卵巢囊性肿块蒂扭转合并出血性梗死的CT表现具有特征性,正确认识可减少误诊及漏诊。

Objective：To investigate MSCT findings of torsion of ovarian cystic lesions with hemorrhagic infarction.Methods：CT images of seven preoperatively misdiagnosed cases with torsion of adnexal cystic lesion and hemorrhagic infarction,confirmed by pathology from surgery,were retrospectively analyzed.Results：All the 7 cases showed ＂cystic and solid dual mass＂ on MSCT.The cystic mass with hyperdense thick wall on CT was identified in 6 cases,with no enhancement in 5 cases and mild enhancement in 1 case.The intra cystic hemorrhage showed ＂fluid-fluid＂ level sign in one case.The solid mass,due to pedicle torsion,appeared as the irregular mass（n=1）,cord-like（n=3） or hair bun-like structure（n=3）.All the solid masses were hyperdense on CT,with lack of enhancement in 5 cases and mild enhancement in 2 cases.All the 7 cases of bilateral lumps of solid masses were shown to deviate to the twisted side.Conclusion：There were some characteristic CT manifestations of ovarian cystic mass with torsion and hemorrhagic infarction.To correctly understand these should reduce missed diagnosis and misdiagnosis.