MSCT在儿童卵巢扭转中的诊断价值

The value of MSCT in diagnosis of ovarian torsion in children

目的:探究多层螺旋CT(MSCT)检查在儿童卵巢扭转诊断中的应用价值。方法:回顾性分析2014年1月至2018年6月于天津市儿童医院经术后免疫组织化学检查确诊为卵巢扭转的30例女患儿的临床资料与影像资料,年龄2~12岁,中位年龄9.3岁。所有患儿均于术前行腹部MSCT检查,主要观察卵巢扭转后的大小、形态、密度以及子宫附件是否发生异常变化。术后行免疫组织化学检查。结果:30例卵巢扭转患儿中,发生于右侧者22例(73.3%,22/30)、左侧者8例(26.7%,8/30);9例(30.0%,9/30)证实为单纯性卵巢扭转、21例(70.0%,21/30)合并占位性病变。MSCT检查结果显示,27例(90.0%,27/30)患侧卵巢均有不同程度肿大伴密度增高,8例(26.7%,8/30)伴有钙化,13例(43.3%,13/30)显示卵巢周边蜂窝状改变的增大滤泡,12例(40.0%,12/30)出现周围脂肪间隙模糊,20例(66.7%,20/30)子宫不同程度向患侧卵巢移位,23例(76.7%,23/30)伴有盆腔少量积液。结论:MSCT可作为儿童卵巢扭转的重要辅助诊断手段,有助于提高卵巢扭转的检出率,为临床治疗提供参考依据。

Objective To explore the value of multislice spiral CT(MSCT)in the diagnosis of ovarian torsion in children.Methods The clinical and imaging data of 30 female children with ovarian torsion confirmed by postoperative immunohistochemistry in Tianjin Children's Hospital from January 2014 to June 2018 were retrospectively analyzed.The children's age ranged from 2 years to 12 years,with a median age of 9.3 years.All children were examined via abdominal MSCT before operation to observe the size,shape,density,and abnormal changes in uterine appendages after ovarian torsion.Immunohistochemical examination was performed after operation.Results Among the 30 cases,ovarian torsion occurred on the right side in 22 cases(73.3%,22/30)and on the left side in 8 cases(26.7%,8/30).Nine cases(30.0%,9/30)were confirmed as having simple ovarian torsion,and 21 cases(70.0%,21/30)were complicated with space-occupying lesions.The MCST results showed that 27 cases(90.0%,27/30)of the affected ovaries had different degrees of enlargement with increased density,8 cases(26.7%,8/30)had calcification,and 13 cases(43.3%,13/30)showed enlarged follicles with honeycomb changes around the ovaries.Meanwhile,12 cases(40.0%,12/30)showed blurred peripheral fat space,20 cases(66.7%,20/30)had different degrees of uterine displacement to the affected ovary,and 23 cases(76.7%,23/30)had a small amount of accumulated pelvic fluid.Conclusions MSCT can be used as an important auxiliary diagnostic tool for ovarian torsion in children.It can help improve the detection rate of ovarian torsion and provide a reference for clinical treatment.