3例女性盆腔脾种植超声图像分析

Ultrasonographic features of pelvic splenosis in 3 female patients

目的 探讨女性盆腔脾种植超声图像特点。方法 回顾性分析经手术病理证实的3例女性盆腔脾种植共计7个包块的临床及超声图文资料,分析总结其特点。结果 盆腔脾种植包块71.43%（5/7）位于右卵巢旁,28.57%（2/7）位于左卵巢旁;二维超声均表现为盆腔内稍强于子宫肌壁的实性均匀等回声,无囊性,边界清楚,有包膜;彩色多普勒超声显示肿物内血流丰富：AlderⅡ级,占57.14%（4/7）,AlderⅢ级,占42.86%（3/7）;测量其中5个肿物的血流频谱,均呈中等阻力型（RI：0.55-0.63）。结论 女性盆腔脾种植具有实性、均匀、稍强于子宫肌壁的等回声等超声图像特征,AlderⅡ-Ⅲ级,中等阻力,结合脾切术史,在诊断脾种植和鉴别妇科疾病时具有重要价值。

Objective To study the imaging features of female pelvic splenosis using ultrasonography. Methods The clinical and sonographic data of 3 cases, a total of 7 masses histopathologically proved as pelvic splenosis, were retrospectively analyzed. Results There were 71.43% （5/7） of pelvic splenosis found to localize to the right ovary and 28.57% （2/7） to the left ovary. Twodimensional gray-scale sonographic imaging revealed a slightly stronger homogeneous echo in the pelvic cavity compared to the echoes detected in the myometrium. The masses were non-cystic showing clear boundary with capsule. The color Doppler uhrasonography showed sufficient blood supply of the masses. The degree of blood flow was graded to Adler I1 and m, accounting for 57. 14% （4/7） and 42.86% （3/7）, respectively. The resistance index （ RI ） of blood flow measured in 5 pelvic splenosis was moderate （ RI ： 0. 55 - 0. 63 ）. Conclusion The uhrasonographic imaging of pelvic splenosis is featured with homogeneous echo pattern, which is a slightly stronger than echo in myometrium. The blood flow is classified to Adler Ⅱ-Ⅲ grade with moderate resistance. The typical sonography features combined with splenectomy history is important for the diagnosis of pelvic splenosis and distinguishing it from other gynecological disease.