原发性输卵管癌的超声诊断

Ultrasound diagnosis of primary fallopian tube carcinoma

目的:分析原发性输卵管癌(primary fallopian tube carcinoma,PFTC)声像图表特征、临床资料,旨在探讨PFTC的声像图表特征,为临床术前诊断提供依据。方法:收集2018年3月-2020年1月经浙江大学医学院附属妇产科医院手术病理证实的原发性输卵管癌患者16例病理、临床资料、超声图像进行分析。结果:16例患者中,14例单侧,1例双侧,1例术前未发现附件包块。肿块大小2.0cm×1.9cm×1.6cm^12.4cm×10.4cm×6.6cm。16例患者中15例发现盆腔肿块,超声表现:附件区见不规则肿块,无包膜,内呈混合性回声,多为腊肠形、壁厚的囊性结构,囊壁有时可见菜花样突起。9例彩色多普勒血流成像(color Doppler flow imaging,CDFI)显示实性部分可见血流,动脉血流阻力指数(resistance index,RI)0.33~0.65,平均(0.47±0.09)。超声提示:输卵管积液1例,卵巢癌4例,输卵管癌5例,盆腔恶性肿瘤5例。结论:原发性输卵管癌有特征性超声图像,结合病史、临床表现及肿瘤标记物检测,经阴道超声检查对PFTC 术前诊断及术后病理分期的预测有重要价值。

Objective This paper analyzes the characteristics and clinical data of primary fallopian tube carcinoma (PFTC) sonogram chart,and aims to explore the characteristics of sonogram chart of PFTC,and provide basis for clinical preoperative diagnosis.Methods 16 patients with primary fallopian tube carcinoma confirmed by surgery and pathology from the Women’s Hospital,Zhejiang University School of Medicine from March 2018 to January 2020 were collected for analysis of pathology,clinical data and ultrasound images.Results Of the 16 patients,14 were unilateral,1 bilateral,and 1 had no accessory mass before surgery.The size of the mass was 2.0cm × 1.9cm × 1.6cm^12.4cm × 10.4cm × 6.6cm.Pelvic masses were found in 15 of 16 patients.Ultrasound manifestations:irregular masses were seen in the attachment area,without capsules,and mixed echoes were present.Most of them were sausage-shaped,thick-walled cystic structures,and cauliflower-like protrusions were sometimes seen on the cyst wall.Nine cases of color Doppler flow imaging (CDFI) showed solid blood flow,arterial blood flow resistance index (RI) 0.33~0.65,average (0.47±0.09).Ultrasound prompts:1 case of tubal effusion,4 cases of ovarian cancer,5 cases of fallopian tube cancer,5 cases of pelvic malignant tumor.Conclusion Primary tubal cancer has characteristic ultrasound images,combined with medical history,clinical manifestations,and tumor marker detection.Transvaginal ultrasound examination is of great value in the preoperative diagnosis and pathological staging of PFTC.