多层螺旋CT对输卵管炎的诊断价值

Diagnostic value of multi-slice spiral CT in salpingitis

目的分析输卵管炎的多层螺旋CT(MSCT)影像学特点,评估MSCT对输卵管炎的鉴别诊断价值。方法选择15例经手术和病理证实的输卵管炎患者,年龄42~75岁,平均年龄58.5岁。分析其MSCT表现,包括病变位置、形态、大小、密度、内部结构、强化程度、边界等。并与病理学结果对比分析。结果 15例患者共26个病灶,双侧11例,单侧4例。化脓性输卵管炎7例13个病灶,MSCT表现为管壁增厚伴有明显强化,其中管壁呈管状及腊肠样5例,管径增粗,囊状及囊实性2例,囊壁及分隔可见强化;输卵管卵巢脓肿2例单侧,呈囊实性混杂密度,壁厚伴强化;慢性输卵管炎6例,输卵管壁略增厚伴强化,其中伴有积水3例。结论 MSCT检查能较好地显示输卵管炎症引起的形态结构改变,并可观察盆腔器官组织的受累及粘连情况,可对输卵管炎症做出准确诊断,对附件区包块的鉴别诊断有重要价值。

Objective To analyze imaging features of salpingitis by multi-slice spiral CT(MSCT), and evaluate differential diagnosis value of MSCT for salpingitis. Methods A total of 15 patients with salpingitis confirmed by surgery and pathology were enrolled, aged 42-75 years old with mean age of 58.5 years old. The MSCT feathers of lesion location, shape, size, density, internal structure, degree of enhancement, borders were analyzed, and compared with pathological results. Results A total of 26 lesions were found in 15 cases, with 11 of bilateral and 4 of unilateral. There were 13 lesions in 7 cases of suppurative salpingitis, and MSCT showed thicken of wall with obvious reinforcement. Among them, 5 cases were tubular and sausagelike, the diameter of tube was thickened;2 cases were cystic and solid-cystic, the wall was separate and enhanced;2 cases of fallopian tube ovarian abscess was unilateral with cystic solid promiscuous density, wall thickness with reinforcement;6 cases of chronic salpingitis, the tubal wall was slightly thickened with reinforcement, among them 3 cases had hydronephrosis. Conclusion It is demonstrated that MSCT could characteristic display morphological changes caused by tubal inflammation, and detect the involvement and adhesion of pelvic organs, which could make accurate diagnosis in tubal inflammation and show important value for the differential diagnosis of accessory mass.