原发性输卵管癌的超声影像学特征分析

Ultrasonographic Characteristics of Primary Fallopian Tube Carcinoma

目的回顾原发性输卵管癌的特征性超声图像及临床资料,为超声早期诊断提供依据。方法对某院2012年5月1日-2022年11月30日经手术病理证实的49例原发性输卵管癌患者的临床资料进行回顾性分析,对超声图像特征进行归类分为4组,A组6例,超声表现:附件区“腊肠样”囊性包块,内壁不光滑,可见乳头状中等回声凸起,可见不完全条形分隔,乳头状凸起及分隔上可见较丰富血流信号。B组19例,超声表现:附件区囊实性包块,部分区域可呈腊肠样改变,囊性部分透声差,实性部分较丰富血流信号。C组20例,超声表现:附件区不规则实性肿物,呈低回声,可伴前后穹隆腹膜及大网膜增厚,肿块内较丰富血流信号。D组4例,超声表现:未发现附件区包块,其中3例伴有腹水,考虑恶性肿瘤所致,来源待查。比较分组后术后病理诊断与分期情况。结果49例患者年龄46~85岁。症状以阴道不规则出血较多见。A组术前超声诊断准确率50%;B组术前超声诊断准确率10.5%;C组与D组均提示盆腔恶性肿瘤。49例患者术后FIGO病理分期:Ⅰ期6例,Ⅱ期14例,Ⅲ期18例,Ⅳ期11例。结论原发性输卵管癌的特征性超声图像包括:双侧卵巢形态完整,显示清晰;附件区呈腊肠样囊性/囊实混合/实性包块,CDFI及CDE显示实性部分有丰富/较丰富血流信号,乳头状凸起内有丰富/较丰富的低阻血流信号;低流速的新生血管。

Objective The characteristic ultrasound images and clinical data of primary tubal carcinoma were reviewed to provide the basis for early diagnosis.Methods The clinical data of 49 patients with primary tubal cancer confirmed by operation and pathology in a hospital from May 1st,2012 to November 30th,2022 were retrospectively analyzed,and the ultrasonic image features were classified into 4 groups,Group A 6 cases,ultrasonic findings:"Dachshund-like"cystic mass in the accessory area,the inner wall was not smooth,papillary medium echo protrusion could be seen,incomplete strip separation could be seen,rich blood flow signals could be seen on the papillary protrusion and separation.There were 19 cases in group B,and the ultrasonographic findings were as follows:cystic mass in the adnexal area,part of the area could show dachshund-like changes,the cystic part had poor sound transmission,and the solid part was rich in blood flow signal.In group C,20 cases showed ultrasonographic findings:irregular solid masses in the adnexal region,with hypoechoic appearance,accompanied by anterioral and anterioral fornix peritoneum and greater omentum thickening,and abundant blood flow signals in the mass.4 cases in group D,ultrasonic findings:no adnexal mass was found,3 cases were accompanied by ascites,which was considered to be caused by malignant tumor,the source of which was to be determined.Postoperative pathological diagnosis and staging were compared after grouping.Results 49 patients were aged 46~85 years.Symptoms to vaginal irregular bleeding more common.The accuracy of preoperative ultrasonic diagnosis in group A was 50%;The accuracy of preoperative ultrasonic diagnosis in group B was 10.5%;Both groups C and D suggested pelvic malignancy.Postoperative FIGO pathological staging of 49 patients was as follows:stageⅠ(6 cases),stageⅡ(14 cases),stageⅢ(18 cases),stageⅣ(11 cases).Conclusions The characteristic ultrasound images of primary tubal carcinoma include:bilateral ovaries with complete morphology and clear display;The adnexal area showed a dachnoid cystic/cystic solid mixed/solid mass.CDFI and CDE showed abundant/relatively abundant blood flow signals in the solid part,and abundant/relatively abundant low resistance blood flow signals in the papillary protrusion,low velocity neovascularization.