卵巢肿瘤蒂扭转的临床及影像学特征分析

Clinical and Imaging Characteristics of Ovarian Tumor Pedicle Torsion

目的分析卵巢肿瘤蒂扭转的临床及影像学特征。方法收集经手术证实卵巢肿瘤蒂扭转患者69例为实验组,选择同期卵巢肿瘤未发生扭转患者70例为对照组,分析两组患者的临床表现、实验室指标及CT/MRI影像学特征,并评价各影像学特征的诊断效能。结果(1)临床表现:实验组患者年龄(t=3.04,P<0.05)、腹部持续性剧痛比例(χ^(2)=67.83,P<0.05)高于对照组。(2)实验室指标:实验组中性粒细胞百分比(t=12.41,P<0.05)及D二聚体测值(t=2.66,P<0.05)高于对照组。(3)影像学特征:实验组以下征象发生率较高,包括“双肿块”征(χ^(2)=71.50,P<0.05)、瘤内出血(χ^(2)=4.53,P<0.05)、肿瘤囊壁增厚(χ^(2)=43.86,P<0.05)、蒂内低密度/“信号”征(χ^(2)=80.09,P<0.05)、“漩涡”征(χ^(2)=43.90,P<0.05)。(4)影像学特征诊断效能:“双肿块”征敏感性最高(95.7%),“漩涡”征特异性最高(100%),“蒂内低密度”征/低“信号”征诊断价值最高,ROC曲线下面积为0.877。结论卵巢肿瘤蒂扭转具有多种临床及CT/MRI特征,正确认识有利于提高本病的术前诊断率。

Objective To analyze the clinical and imaging features of ovarian tumor pedicle torsion.Methods A total of 69 patients with ovarian tumor pedicle torsion proven by surgery and 70 control patients without ovarian tumor torsion were enrolled in our study.Analyses the clinical manifestations,laboratory indicators and CT/MRI imaging characteristics of the two groups,and the diagnostic efficacy of each imaging feature.Results(1)Clinical manifestations:The age of patients in the experimental group(t=3.04,P<0.05)and the persistent severe abdominal pain(χ^(2)=67.83,P<0.05)was higher than that of control group.(2)Laboratory indicators:the percentage of neutrophils(t=12.41,P<0.05)and D dimmer(t=2.66,P<0.05)in the experimental group were higher than the control group.(3)Imaging features:The incidence of the following signs was higher in the experimental group,including double mass sign(χ^(2)=71.50,P<0.05),intratumoral hemorrhage(χ^(2)=4.53,P<0.05),tumor wall thickening(χ^(2)=43.86,P<0.05),intradermal low density/signal sign(χ^(2)=80.09,P<0.05),whirlpool sign(χ^(2)=43.90,P<0.05).(4)Diagnostic efficacy of imaging features:The sensitivity of double mass sign was the highest(95.7%),the specificity of whirlpool sign was the highest(100%),the diagnostic value of low density sign/low signal sign in pedicle was the highest,ROC=0.877.Conclusion Pedicle torsion of ovarian tumor has many clinical and CT/MRI features,correct recognition is beneficial to improve the preoperative diagnosis rate of this disease.