输卵管卵巢脓肿及输卵管积水的多层螺旋CT表现及诊断价值

The Findings and Diagnostic Value of Multislice Spiral CT in Tubal Ovarian Abscess and Hydrosalpinx

目的研究多层螺旋CT诊断输卵管卵巢脓肿及输卵管积水的临床价值。方法选取我院67例输尿管卵巢脓肿及输尿管积水患者为研究对象,均经手术病理证实,其中输卵管卵巢脓肿39例,输卵管积水28例,采取西门子Sensation 64层螺旋CT机对上述患者进行检查,分析输卵管卵巢脓肿及输尿管积水的CT影像学特点。结果 67例患者共检出87侧输卵管病变,所有患者均可见单、双侧子宫囊状及混杂密度肿块,管状型56例,多囊型15例,单囊型16例。输卵管卵巢脓肿管状型35例,多囊型7例,单囊型2例;输卵管积水管状型22例,多囊型8例,单囊型13例;卵巢脓肿主要表现为厚壁肿块,边界模糊,内壁清晰,增强扫描后可见均匀或分层状强化,液性部分未见强化,肿块周围条索影和脂肪密度上升。输卵管积水CT表现主要为囊状肿块、多囊状、管状,其中多囊状发生率明显高于输卵管卵巢肿块,壁光清晰,强化扫描后强化轻微。结论多层螺旋CT可准确鉴别输卵管卵巢脓肿及输卵管积水,通过分析两种疾病类型的CT影像学差异,可对治疗方案的制定提供可靠依据。

Objective To study the clinical value of multi-slice spiral CT m the diagnosis of tubal ovarian abscess and hydrosalpinx. Methods 67 cases of patients with tubal ovarian abscess and hydrosalpinx in the hospital were selected as the research objects. All patients were confirmed by surgery and pathologW. There was tubal ovarian abscess in 39 cases and hydrosalpinx in 28 cases. The Siemens Sensation 64 slice spiral CT machine was used to examine tl^e patients. The CT imaging features of tubal ovarian abscess and hydrosalpinx were analyzed. Results There were 87 Edlopian tube lesions detected in 67 cases of patients. All patients were with visible, bilateral uterine cystic and mixed density masses, including tubular type in 56 cases, polycystic type in 15 cases and single cystic type in 16 cases. There were tubal ovarian abscesses of tubular type in 3B cases, polycystic type in 7 cases and single cystic type in 2 cases; hydrosalpinx of tubular type in 22 cases, polycystic type in 8 cases and single cystic type in 13 cases. The main features of ovarian abscesses were thick wall masses, blurred boundaries and clear inner wall. After enhancement scan, there were homogeneous or layering enhancement while there was no enhancement in the liquid part. Stripes around masses and fat density increased. The CT findings of hydrosalpinx mainly were cystic masses, polycystic and tubular, in which the incidence rate of polycystic shape was significantly higher than that of tubal ovarian masses, with clear wall light. After enhancement scan, the enhancement was slight. Conclusion Multi- slice spiral CT can accurately identify tubal ovarian abscess and hydrosalpinx. Through analyzing the differences in CT imaging of the two kinds of diseases, reliable basis can be provided for making treatment plan.