卵巢过度刺激综合征的CT表现(附6例报道及文献复习)

CT Appearances Ovarian Hyperstimulation Syndrome:6 Case Reports and Review of the Literature

目的探讨卵巢过度刺激综合征(OHSS)的CT表现。方法回顾性分析2011年至2017年本院6例OHSS患者的临床及CT表现。5例发生于超声引导下取卵之后3~4天内,1例发生于难免流产后3天。结果6例患者CT均表现为双侧卵巢明显增大,卵巢最大径线7.9~13.0 cm,多个卵泡扩张积液,5例患者部分卵泡内见高密度出血,增强扫描卵巢中央间质及卵泡壁强化,卵泡内液体及出血不强化,呈"轮辐状"改变。4例患者伴有大量腹腔积液,2例少量腹腔积液,1例伴腹盆腔血性积液。4例伴少量胸腔积液。结论OHSS的CT表现为双侧卵巢多囊性增大,增强扫描呈典型"轮辐状"表现,CT检查有助于其诊断及鉴别诊断。

Objective To explore the CT appearances of ovarian hyperstimulation syndrome(OHSS).Methods Retrospectively analyze the clinical and CT appearances of 6 OHSS cases in our hospital examined from 2011 to 2017,5 cases scanned within 3-4 days after ultrasound guided ovum retrieval,and 1 case scanned 3 days after inevitable abortion.Results CT scanning showed bilateral ovarian enlargement with a maximum diameter of 7.9 cm to 13.0 cm in the 6 cases,multiple enlarged follicles,and high density hemorrhage in some follicles in 5 cases.The ovarian central stroma and follicular wall enhanced at CT contrast enhanced scanning,and the fluid-filled and hemorrhagic follicles lacked enhancement,with demonstration of the classic"spoke-wheel"appearance.There were 4 cases with massive peritoneal effusion,2 cases with small amount of peritoneal effusion,1 case with abdominal and pelvic hemorrhage,4 cases with small amount of pleural effusion.Conclusion The typical CT findings of the OHSS reveals bilateral multicystic ovarian enlargement,giving the classic"wheel-spoke"appearance at contrast enhanced scanning.CT scanning is helpful for the diagnosis and differential diagnosis of OHSS.