CT与CA-125检测在盆腔子宫内膜异位囊肿诊断中的应用

The application of CT and CA-125 test on diagnosis of pelvic endometriotic cyst

目的分析盆腔子宫内膜异位囊肿的CT表现,结合CA-125检测提高CT诊断水平。方法回顾性分析经手术和病理证实的23例盆腔子宫内膜异位囊肿的CT表现,并将子宫内膜异位囊肿组与对照组CA-125检测数据进行统计学分析。结果 CT发现卵巢子宫内膜异位囊肿20例23个囊肿以及右侧阔韧带异位囊肿、左侧阔韧带与子宫前壁间异位囊肿、腹壁切口子宫内膜异位囊肿各1个,共26个囊肿。病灶长径33～111mm,平均(67±24)mm;单房8个,双房1个,多房17个;囊肿壁<3 mm 22个,囊壁≥3 mm 4个;囊肿边界模糊21个,边缘清晰5个;囊内CT值5～65 Hu;增强扫描囊壁轻中度强化22个,明显强化4个,囊内均未见强化。23例盆腔子宫内膜异位囊肿CA-125检测阳性19例,平均(63±30)U/mL,与对照组比较有统计学意义(P<0.05)。结论 CT能较大程度显示盆腔子宫内膜异位囊肿的形态特征,CT结合CA-125检测可提高诊断正确率。

Objective To improve the diagnostic accuracy of pelvic endometriotic cyst and discriminate it from other adnexal masses by analyzing its CT manifestations and CA-125 test. Methods The CT images of 23 pa- tients proved by surgery and pathology were studied retrospectively. The CA-125 test data of,82 patients which were divided into the endometriotic cyst group and control groups were statistically analyzed. Results Totally 26 cysts were found in 23 cases, in which there were 23 ovarian endometriotic cysts in 20 cases. The cysts ranged in diameter from 33 to 111 mm with the mean size of （67＋24）mm. Unilocular, bilocular and muhilocular forms were seen respec- tively in 8, 1 and 17 of 26 endometriotic cysts. Thin and thickened wails were found respectively in 22 and 4 of 26 endometriotic cysts. The margins of the cyst were sharp in 5 and ill defined in 21 endometriotic cysts. The density of the cyst fluid varied from 5-65 Hu. The slight or intermediate enhancement of the wall of endometriotic cysts in 22, and the significant enhancement in 4 were demonstrated. In the endometriosis group, CA-125 was positive in 19 cases, mean （63±30）U/mL, Statistical analysis showed that compared with the control groups, there were significant differences. Conclusion The certain morphologic characteristics of the pelvic endometriotic cysts can be showed by CT in higher extent. CT combining with CA-125 test can improve the diagnostic accuracy.