经阴道彩色多普勒超声对输卵管卵巢脓肿的诊断价值

Diagnostic value of transvaginal color Doppler ultrasound for tubo-ovarian abscess

目的总结输卵管卵巢脓肿(TOA)的超声图像特征,探讨超声诊断TOA的临床意义和价值。方法抽取2017年7月至2020年1月于河南省人民医院经腹腔镜手术或穿刺病理结果诊断为TOA的患者38例为研究对象,总结不同类型TOA的超声表现。结果38例TOA病灶分为囊性7例、囊实混合性21例、实性10例。囊性包块超声表现为附件区厚壁囊性无回声盘曲,内透声差。囊实混合性包块超声表现为复杂厚壁多房混合回声,边界不清,形态不规则,内透声差。实性包块超声表现为低回声,形态规则,边界请,内可见丰富血流信号。TOA的超声定位诊断敏感性为86%(33/38),定性诊断敏感性为79%(30/38)。结论超声可作为TOA的首选检查方法,对临床诊断及治疗有重要价值。

Objective To summarize the ultrasonographic characteristics of tubo-ovarian abscess (TOA), and to investigate the clinical significance and value of ultrasound in diagnosis of TOA.Methods Thirty-eight patients with TOA confirmed by laparoscopic surgery or puncture pathology in Henan Provincial Hospital from July 2017 to January 2020 were selected as research objects. And the ultrasound manifestations of different types of TOA were summarized.Results The 38 cases of TOA lesions were classified as cystic mass (7 cases), mixed cystic-solid mass (21 cases), and solid mass (10 cases). Cystic mass manifested as cystic unechogenic coiling in the accessory area, thickened wall, and internal complex fluid according to ultrasonography. The mixed cystic-solid mass manifested as complex thick-wall, mixed echo in multi-room with unclear boundaries, irregular shapes, and poor internal sound transmission according to ultrasonography. The solid mass was characterized by low echo, regular morphology, visible borders, and rich blood flow signals inside according to ultrasonography. The localization diagnosis accordance rate of the ultrasonographic imaging for TOA was 86% (33/38), and the qualitative diagnosis accordance rate was 79% (30/38).Conclusions The ultrasonography can be the first-line preoperative imaging investigation in the diagnosis of TOA. It can provide important value for clinical diagnosis and treatment.