卵巢冠囊肿的CT、MRI表现及误漏诊分析

Analysis of CT and MRI appearances and misdiagnosis of parovarian cysts

目的:分析卵巢冠囊肿的CT及MRI表现,提高其术前诊断准确率。方法:收集经手术和病理证实的35例(共42个囊肿)卵巢冠囊肿患者的CT及MRI图像,分析病灶部位、病灶与卵巢及阔韧带关系、大小、形态及张力程度、囊壁及分隔情况、囊液CT值及MRI信号等。结果:42个卵巢冠囊肿,CT及MRI检出36个,位于附件区27个(75.0%),囊肿同侧卵巢可见14个(38.9%),同侧阔韧带呈抱球征23个(63.9%),最大径<5 cm 22个(61.1%),呈类圆形或类椭圆形34个,呈眼镜蛇形2个,呈低度张力21个,囊肿伴分隔5个,囊液CT值≤15 HU 34个,T1WI呈低信号、T2WI呈高信号35个。42个卵巢冠囊肿,术前正确诊断1个,漏误诊41个(97.6%)。结论:卵巢冠囊肿的CT及MRI表现有一定特征,病灶同侧卵巢显示联合阔韧带呈抱球征可提高诊断准确率,且病灶呈眼镜蛇形对诊断该病有一定特异性。

Objective:To analyze the CT and MRI manifestations of parovarian cysts to improve the accuracy of preoperative diagnosis.Methods:The CT and MRI images of 35 patients(42 cysts in total)with parovarian cysts confirmed by surgery and pathology were collected,the imaging features such as the location of the lesion,the relationship between the lesion and the ovary and broad ligament,the size,shape and tension,the cyst wall and separation,the CT value of cyst fluid and MRI signal were analyzed.Results:There were 42 parovarian cysts,36 cysts were detected by CT and MRI,27 cysts were located in the adnexal area(75.0%).14 ovaries(38.9%)were seen on the same side of the cysts.There were 23(63.9%)cysts with‘balloon sign’in the ipsilateral broad ligament,22(61.1%)cysts with a maximum diameter of less than 5 cm.Among the 36 cysts 34(94.4%)cysts were round or elliptical shapes,2 cysts were cobra-shaped.There were 21 cysts with low tension,5 cysts with separation,fluid CT values were less than or equal to 15 HU in 34 cysts,MRI images showed low signal on T1WI and high signal on T2WI in 35 cysts.In a total of 42 cysts,only 1 cyst had been diagnosed preoperatively,41(97.6%)cysts had missed diagnosed or misdiagnosed.Conclusions:The CT and MRI manifestations of parovarian cysts have certain characteristics,the ovaries on the ipsilateral side of the cysts and‘ballon sign’of the broad ligament can improve the accuracy of diagnosis.At the same time,the‘cobra-shaped’which has certain specificity for the diagnosis of parovarian cysts.