卵巢正常大小卵巢癌综合征18例多层螺旋CT检查结果分析

Analysis of MSCT in 18 Cases of Normal-sized Ovary Carcinoma Syndrome

目的:探讨多层螺旋CT诊断卵巢正常大小卵巢癌综合征(NOCS)的应用价值。方法:回顾性分析经病理检查证实的18例NOCS患者的多层螺旋CT表现。结果:术前CT明确诊断为NOCS 17例,误诊为结核性腹膜炎1例,诊断符合率为94.4%。双侧附件正常大小或稍大,卵巢形态正常2例;卵巢形态不规则16例,其中呈结节样10例(1例伴钙化),小囊实性6例;18例"卵巢血管蒂"征阳性。18例均有大网膜呈"饼状"或(和)结节样增厚,2例腹膜增厚伴有钙化,4例肠系膜结节样增厚,2例胃结肠韧带、脾胃韧带增厚。17例有不同程度的腹水。4例盆腔或腹膜后淋巴结显示,其中2例有淋巴结稍增大。1例肝右后叶下段低密度灶。结论:CT检查NOCS有一定的特征性,对腹膜种植转移灶的检出有一定的敏感性,能有效地提示淋巴结转移,可全面反映病灶形态及毗邻关系。

Objective：To evaluate the value of multi-slice spiral computed tomography（MSCT） in the diag- nosis of normal-sized ovary carcinoma syndrome （NOCS）. Methods： MSCT manifestations of 18 cases NOCS which were confirmed by pathologically examintation were analyzed retrospectively. Results：17 cases were preoperatively diagnosed as NOCS,1 case was misdiagnosed as tuberculous peritonitis. The accuracy of MSCT diagnosis in NOCS was 94.4%. The ovaries were in normal size or slightly accrescent,2 cases with normal shape,16 cases with irregular shape, among which, 10 cases presented small nodular on enhanced scan（ 1 case with calcification） ,6 cases showed small solid cystic lesion. All the cases had the ovarian vascu- lar pedicle sign. All the 18 cases had omental nodular thickening or/and cake sign,2 cases had peritoneal thickening with calcification,4 cases had mesenteric nodular thickening ,2 cases had gastrocolic ligament and splenogastric ligament thickening. 17 cases had ascites in different degree. Pelvic and retroperitoneal lymph nodes were shown in 4 cases,2 cases of which were slightly accrescent. 1 case had low density lesion in lower section of right rear hepatic lobe. Conclusions：NOCS has characteristic features on MSCT. MSCT has high sensitivity in detection of peritoneal metastases,could effectively show lymph node metastasis, and could dis- play more intuitionistic and comprehensive lesion shape and adjacent relationships.