卵巢良性病变的CT表现

CT Findings of Benign Ovarian Masses

目的 提高对卵巢良性病变CT表现的认识。材料与方法 回顾性分析经手术病理证实的 66例共 80个卵巢良性肿块的CT及B超资料 ,讨论其CT表现特点及CT在诊断中的作用。结果 本组 2 5个功能性囊肿CT发现 2 3个 ;18个卵巢子宫内膜异位囊肿 ,长径多与同侧的盆壁近乎平行 ( 12 /18) ,甚至大于横径达 1.5倍 ( 9/18) ;15个囊腺瘤均呈边缘光滑的囊性肿块 ,其中浆液性囊腺瘤 (n =9)密度均匀 ,多为单房 ( 6/9) ,粘液性囊腺瘤 (n =6)密度较高或有数种分界清楚的液性密度影 ,常呈多房 ( 4 /6) ;14个成熟性囊性畸胎瘤均含有脂肪密度区 ,该组术前还作了B超检查 ,其敏感性和特异性均低于CT ;2个卵泡膜细胞瘤肿块以实质性为主 ,且伴有少量腹水 ;1例囊性腺纤维瘤肿块呈囊实性 ;5个卵巢炎性肿块中 2个为输卵管卵巢结核 ,伴有大网膜改变。结论 卵巢良性肿块CT表现有一定特点 ,特别是卵巢子宫内膜异位囊肿、囊腺瘤和成熟性囊性畸胎瘤 ,且后者的CT检查明显优于B超。

Objective To make a further understanding of CT signs of benign ovarian masses.Materials and Methods CT and US findings of 80 surgically and pathologically proved benign ovarian masses in 60 patients were retrospectively analyzed. Imaging features and CT value in diagnosis were discussed.Results Twenty three of the 25 functional ovarian cysts were detected by CT scans. In 12 of 18 endometriosis, the longitudinal diameter of the mass were parallel to the pelvis wall, and the ratio of longitudinal to transversal diameter was 1.5 in 9 cases. All 15 cystadenomas showed a smooth border. The serous cystadenomas (n=9) were homogeneous and often unilocular (6/9). The mucinous cystadenomas (n=6) were often multilocular (4/6), containing fluid with different attenuation (2/6). All 14 benign cystic teratomas carried fat attenuation. The sensitivity and specificity of CT scans were higher than that of US. Two theca cell tumors presented mainly as solid masses with a little ascetics, while one cystadenofibroma presented as a cystic solid mass. Two of 5 inflammatory masses turned out to be tuberculous with omental involvement.Conclusion Benign ovarian masses, such as endometriosis, cystadenoma and cystic teratoma, have some characteristic CT signs. CT scan is superior to US in diagnosing benign ovarian masses, especially for cystic teratoma.