婴儿卵巢囊肿及其并发症的CT、MRI表现

CT and MRI( Imaging) Findings of Ovarian Cyst and Complications in Infancy

目的探讨婴儿卵巢囊肿及并发症的CT及MRI表现。方法回顾性分析22例经手术病理证实的婴儿卵巢囊肿的CT、MRI资料,其中CT检查11例（10例为增强检查）,MRI检查10例（7例为增强检查）,同时行CT增强及MRI增强检查1例。总结其影像表现特点。结果 22例患者中,21例在胎龄24周-39周（平均约33周）时超声发现,1例于出生后3个月发现。所有病灶均位于中下腹部,左侧9例,右侧13例,病灶最大径2.7-8.8cm,平均5.0 cm。单纯性囊肿9例,表现为腹腔类圆形无强化囊性灶,壁菲薄;复杂性囊肿13例,其中6例发生扭转（左、右侧各3例）,表现为囊内出血,形成液-液平面5例,伴囊壁增厚1例,5例可见钙化,4例钙化位于病灶内缘,呈三角形;3例卵巢囊肿自截,位于右侧2例,左侧1例,均表现为出血性囊肿伴钙化,钙化可位于前缘或内缘或呈三角形;1例发现病灶位置变化。另外4例复杂性囊肿为囊内出血伴或不伴囊壁钙化,钙化位于病灶内缘或后缘。13.6%（3/22例）可见子囊。结论卵巢囊肿为女性胎儿最常见腹部囊性病变,复杂性囊肿常与出血、扭转有关,位于病灶内缘的三角形钙化提示扭转或自截。结合囊壁钙化、囊内出血和病灶位置变化,可提高对卵巢自截诊断的准确率。

Objective To access CT and MRI imaging features of ovarian cyst and its complications in fetal-infancy and to improve accuracy of diagnosis. Methods CT and MRI imaging studies of ovarian cysts in 22 patients that was proved by surgery and pathology,were analyzed retrospectively. 11 cases underwent CT scan（ 10 had contrast enhancement）,10 cases underwent MRI scan（ 7 cases had contrast enhancement）,1 case had both enhanced scans. Results All lesions were diagnosed by prenatal ultrasonography apart from one found at 3 months,diagnosis time ranged from 24 to 39 gestational weeks（ mean 33 weeks）. All lesions located in the middle lower abdomen,9 on the left and 13 on the right. The maximum diameter varied from 2. 7 to 8. 8 cm（ mean 5 cm）. All simple cysts（ 9 cases） presented as a cystic lesion with a thin wall and no enhancement. Out of 13 complex cysts,6 lesions were observed to possess torsion and 3 leisons displayed autoamputation. Among those with ovarian torsion,bilateral lesions were seen in half,hemorrhage was seen in 5 cases,one had thickened wall,5 cases showed calcification,80% calcification located in the inner margin and presenting as a triangular shape. 3 lesions with autoamputation,2 in right and 1 in left,showed hemorrhage and calcification,which located in the anterior or inner margin or presented as a triangular shape,one was found to have side changes. Another 4 complex cyst presented with hemorrhage or calcification. ＂ Daughter cysts＂ were seen in 3 cases. Conclusion Fetal ovarian cyst is the most common abdominal cysts observed in the female fetus. Complex cysts are often associated with hemorrhage and torsion. Triangular calcification was located in the inner margin and indicated the diagosis of ovarian torsion and autoamputation. Ovarian autoamputation showed hemorrhage and calcification,accuracy of diagnosis would be improved if combined with side change of the lesion.