儿童卵巢肿瘤蒂扭转彩色多普勒超声诊断

Color Doppler flow imaging in diagnosis of ovarian tumors with pedicle torsion in children

目的探讨彩色多普勒超声对儿童卵巢肿瘤蒂扭转的诊断价值。方法分析2007年3月～2012年3月收治于我院疑似卵巢肿瘤蒂扭转的22例患儿的超声图像,并根据扭转的卵巢肿瘤内部、周边或旁边血管蒂的彩色多普勒分为3类,与手术及病理结果进行比较。结果 22例患儿中I类有12例,卵巢肿瘤内部、周边或旁边血管蒂无明显血流信号。II类有6例,卵巢肿瘤内部、周边或旁边血管蒂仅见动脉血流;III类有4例,卵巢肿瘤内部、周边或旁边血管蒂内见少量动静脉血流。I类、II类患儿术后病理诊断切除的肿瘤和附件均有出血性坏死,III类术中见卵巢颜色正常或卵巢肿瘤不全扭转,保留卵巢并剥除肿瘤送病理检查无坏死。18例超声诊断与手术及病理结果相符,故超声诊断符合率为82%(18/22)。结论彩色多普勒对于儿童卵巢肿瘤蒂扭转早期发现、早期诊断及判断扭转的严重程度具有重要意义。

Objective To explore the values of color doppler ultrasound in diagnosis of ovarian tumors with pedicle torsion in children. Methods Ultrasonic appearance of twenty-two patients were analyzed who were admitted to our hospital from March 2007 to March 2012 due to suspected ovarian tumors with pedicle torsion. All sonograms were compared with surgical and pathological results and divided into there types according to Doppler flow of ovary tumors or in the torsion vascular pedicle. Results Of 22 patients, 12 patients of type I showed no blood flow in the ovary tumors or the twisted vascular pedicle. 6 patients of type II showed only the arterial blood flow in the ovary tumors or the twisted vascular. 4 patients of type III showed the arterial and venous blood flow in the ovary tumors or the twisted vascular. Hemorrhagic infarct was detected by pathological examination in the samples of tumor and the appendage in type I and type II. No tissue necrosis was found in type III, so ovaries were reserved. Conclusion Doppler ultrasound has an important value in finding and diagnosis early of ovarian tumors with pedicle torsion in children and can help differentiate the severity of torsion.