原发性输卵管癌的超声诊断分析

Ultrasonographic analysis of primary fallopian tube carcinoma

目的分析总结原发性输卵管癌(primary fallopian tube carcinoma, PFTC)的超声图像特征,为原发性输卵管癌的术前诊断及术后病理分期预测提供更多依据。方法以手术病理结果为金标准,并以CA125检测为参考,评估原发性输卵管癌超声检查的诊断价值。回顾分析并总结2010年8月至2018年6月46例原发性输卵管癌的超声图像特征。结果根据超声声像图分组:A组:术前未发现附件区异常;B组:附件区管状囊性肿物、囊壁上可见乳头状结构、附件区囊实性或实性肿物,实性区内可见丰富或较丰富血流信号;C组:附件区形态不规则实性肿物,并伴有前后穹隆及大网膜增厚,盆腹腔积液,实性区内可见丰富或较丰富血流信号。A组术后病理Ⅰ期(100%,4/4);B组术后病理Ⅰ期(11%,3/28)、Ⅱ期(32%,9/28)、Ⅲ期(57%,16/28);C组术后病理Ⅲ期(71%,10/14)、Ⅳ期(29%,4/14)。结论原发性输卵管癌有特征性超声图像,结合病史、临床表现及肿瘤标记物检测,经阴道超声检查对PFTC术前诊断及术后病理分期的预测有重要价值。

Objective To summarize the characteristics of sonographic patterns of primary fallopian tube carcinoma(PFTC), and to provide more evidence for preoperative diagnosis and postoperative pathological stage prediction of PFTC. Methods The diagnostic value of ultrasonography for primary fallopian tube carcinoma was evaluated with the gold standard of surgical pathological results and CA125 test as reference. The ultrasonographic features of 46 cases of primary fallopian tube carcinoma from August 2010 to June 2018 were retrospectively analyzed and summarized. Results The patients were grouped according to ultrasound sonogram: Group A: No adnexal abnormality was found before operation;Group B:Tubular cystic masses in the adnexal area with papillary structures;Cystic or solid masses in the adnexal area. Doppler ìow imaging shows abundant or relatively abundant blood ìow signals in the solid area. Group C: Irregular and heterogenous adnexal solid mass, with omental and vaginal fornical thickening and ascites. Doppler ìow imaging shows abundant or relatively abundant internal blood ìow signals in the solid area. Postoperative pathology: Group A with stage I(100%, 4/4);Group B with stage Ⅰ(11%, 3/28), stage Ⅱ(32%, 9/28), stage Ⅲ(57%, 16/28);Group C with stage Ⅲ(71%, 10/14), stage Ⅳ(29%, 4/14). Conclusions Primary salpingocarcinoma has characteristic ultrasound images, combined with medical history, clinical manifestation and detection of tumor markers, and transvaginal ultrasonography is of great value for preoperative diagnosis of PFTC and prediction of postoperative pathological staging.