探讨多层螺旋CT多平面重建技术在诊断卵巢囊肿蒂扭转中的应用价值

To evaluate the value of multiplanar reconstruction of multi-slice spiral CT in the diagnosis of ovarian cyst pedicle torsion

目的探讨卵巢囊肿蒂扭转采用多层螺旋CT(MSCT)多平面重建(MPR)技术诊断的价值。方法选择2015年1月至2020年6月于医院检测的45例卵巢囊肿蒂扭转中患者,对患者MSCT及MPR技术资料进行回顾分析,分析对比手术病理组织诊断结果。结果MSCT检测均显示盆腹腔囊性肿块,33例患者囊壁增厚,15例患者囊壁密度不均匀,见分层,囊肿厚度不对称,存在条索状软组织相连,延伸至一侧子宫角部或附件,MPR可见蒂部一端连结子宫角部或附件,另一端连结囊肿,15例患者存在囊壁钙化,有27例患者存在盆、腹腔积液,积液位于子宫直肠陷窝、盆底、囊肿边缘、结肠旁沟、肝肾隐卧、肝周;与手术病理组织诊断结果对比,手术病理诊断准确率高于MSCT(100.00%VS 84.44%)(P<0.05),但MSCT与手术病理对于囊肿平均直径、囊肿加厚厚度检查结果相近(P>0.05),无统计学意义。结论卵巢囊肿蒂扭转在MSCT及MPR技术下有独特的特征表现,清晰显示卵巢囊肿蒂扭转及其积液情况,可了解到患者目前的情况,具有较高临床价值。

Objective To evaluate the value of multiplanar reconstruction(MPR)of multi-slice spiral CT(MSCT)in the diagnosis of ovarian cyst pedicle torsion.Methods 45 patients with ovarian cyst pedicle torsion detected in the hospital from January 2015 to June 2020 were selected.The technical data of MSCT and MPR were retrospectively analyzed,and the diagnostic results of surgical pathology were compared.Results MSCT showed pelvic and abdominal cystic masses.The cystic wall of 33 patients was thickened,and the density of cystic wall was uneven in 15 patients.The cyst thickness was asymmetric.There were strip like soft tissue connected and extended to one uterine corner or accessory.MPR showed that one end of the pedicle was connected to the uterine corner or accessory,and the other end was connected to the cyst.There was cystic wall calcification in 15 patients,There were 27 patients with pelvic and peritoneal effusions,which were located in hysterorectal lacunae,pelvic floor,cyst edge,paracolonic sulcus,liver and kidney reclining and perihepatic;Compared with the results of surgical pathology,the diagnostic accuracy of surgical pathology was higher than that of MSCT(100.00%vs 84.44%)(P<0.05),but the results of MSCT and surgical pathology were similar to those of surgical pathology(P>0.05).Conclusion Ovarian cyst pedicle torsion has unique characteristics under MSCT and MPR technology.It can clearly show the torsion and effusion of ovarian cyst pedicle,understand the current situation of patients,and has high clinical value.