Histopathological patterns of ovarian lesions:A study of 161 cases

Ovarian lesions are commonly encountered pathologies that cannot be categorized clinicoradiologically.Definite diagnosis is of great importance for therapeutic and prognostic purposes.Histopathology gives accurate diagnosis in most cases.Few cases need supportive tests like immunohistochemistry.Objective:to study the histomorphological diversity of ovarian lesions,their age and location in North of Iraq(Mosul and Duhok).Patients and methods:In the period extended from January 2008 to December 2011,161 cases of ovarian lesions were collected from pathology departments in Azadi General Hospital“Duhok”and Al-Jamhori Teaching Hospital“Mosul”.Automated tissue processor was used for histologic study and Streptavidin-biotin method on paraffin sections was applied for immunohistochemistry.Result:There was a wide age range,most being in the third decade.The right ovaries were more common involved than the left.Histologically,58(36%)cases were non-neoplastic and 103 were neoplastic including 90(55.9%)benign and 9(5.6%)malignant tumors.The remaining 4(2.4%)cases comprised borderline serous cystadenoma.Conclusion:Most ovarian lesions were functional non-neoplastic followed by benign neoplastic.Apart from few cases,diagnosis was merely histological without any ancillary test.

Surgicopathological classification of hepatic space-occupying lesions:A single-center experience with literature review

Accompanying rapid developments in hepatic surgery,the number of surgeries and identifications of histological types of primary hepatic space-occupying lesions (PHSOLs) have increased dramatically.This has led to many changes in the surgicopathological spectrum of PHSOLs,and has contributed to a theoretical basis for modern hepatic surgery and oncological pathology.Between 1982 and 2009 at the Eastern Hepatobiliary Surgery Hospital (EHBH) in Shanghai,31 901 patients underwent surgery and were diagnosed as having a PHSOL.In this paper,we present an analysis of the PHSOL cases at the EHBH for this time period,along with results from a systematic literature review.We describe a surgicopathological spectrum comprising more than 100 types of PHSOLs that can be stratified into three types:tumor-like,benign,and malignant.We also stratified the PHSOLs into six subtypes derived from hepatocytes;cholangiocytes;vascular,lymphoid and hemopoietic tissues;muscular,fibrous and adipose tissues;neural and neuroendocrine tissues;and miscellaneous tissues.The present study provides a new classification system that can be used as a current reference for clinicians and pathologists to make correct diagnoses and differential diagnoses among various PHSOLs.

Florid reactive periostitis ossificans of the humerus: Case report and differential diagnosis of periosteal lesions of long bones

A case of florid reactive periostitis ossificans(RPO) arising in a long bone is presented. This is a rare bone proliferation with a pronounced periosteal reaction. Less than 100 cases have been described in the literature with far fewer outside the bones of the hand, feet, fingers, and toes. Although the etiology is unknown, a relationship to preceding trauma is suggested. The imaging and histologic features show an overlap with other bone lesions including bizarre parosteal osteochondromatous proliferation, subungual exostosis, and malignant surface tumors of bone and cartilage which include, periosteal and parosteal osteosarcoma. It is important to recognize the clinical presentation and diagnostic features of RPO as a benign entity so that it is not mistaken for a more aggressive neoplasm. We present a case of a right distal humeral lesion that on histopathological review revealed florid RPO. This diagnosis was not suspected on imaging studies, but was made on open biopsy of the mass. The patient remains disease free, years postoperatively. In addition to presenting this unique case report, we review the pertinent literature, and offer a differential diagnosis and treatment strategy for its management.

Gastric metastasis from ovarian adenocarcinoma presenting as a subepithelial tumor and diagnosed by endoscopic ultrasound-guided tissue acquisition

We describe an uncommon case of a patient with a metastatic adenocarcinoma of ovarian origin presented as a gastric subepithelial tumor(SET) and that was diagnosed by endoscopic ultrasound fine-needle biopsy(EUS-FNB). Malignant gastric lesions are rarely metastatic and the primary tumor is mainly breast, lung, esophageal cancer or cutaneous melanoma. Gastric metastasis from ovarian cancer is unusual, presenting synchronously with the primary tumor but also several years later than the initial diagnosis. From an endoscopic point of view, gastric metastasis does not present specific features. They may mimic both a primary gastric tumor or, less frequently, an SET.This case demonstrates the importance of EUS-FNB in distinguishing SETs and how this may alter treatment and prognosis.

Unusual cause of lesions in the descending duodenum and liver:A case report and review of literature

The descending duodenum is rarely involved in Schistosoma japonicum(S. japonicum) infection. Here, we report a case of acute Schistosoma infection, which presented with abdominal pain, abdominal distension and irregular fever. Tumor-like lesions were observed in the descending duodenum. Simultaneously, heterogeneity in hepatic perfusion was demonstrated by dynamic computed tomography scanning. Biopsy of the descending duodenum showed the deposition of Schistosoma eggs. Following administration of the antihelminthic drug praziquantel, the patient showed rapid clinical improvement. In conclusion, we report a patient with acute S. japonicum infection presenting as tumor-like lesions in the descending duodenum and heterogeneity of blood perfusion in liver parenchyma.

Gross and Microscopic Lesions of the Ovaries of Camels from Abattoirs in Eastern Province of Kingdom of Saudi Arabia

In the present investigation, gross and microscopic lesions of the ovaries were studied in two hundred and ten (210) adult non-pregnant she-camels. Fresh samples of ovaries were collected from she-camels at the point of slaughter in Al-Ahsa abattoir, Eastern region of Kingdom of Saudi Arabia. These samples were subjected to histopathological studies and stained by routine Hematoxylin and Eosin stain. Grossly, of the 210 ovarian tissues examined, 30 (14.28%) had ovarian lesions of one type or another, whereas 180 (85.71%) camels were apparently healthy. Only 6 (2.85%) ovaries showed unilateral ovarian hypoplasia, whereas 4 (1.9%) showed bilateral ovarian hypoplasia. Cystic ovaries were observed in a total of 13 of the collected samples of ovaries, of these 8 (3.8%) were diagnosed as follicular cystic ovaries, while 5 (2.38%) were luteal cystic ovaries. Ovarian abscess appeared in only one sample of the collected ovaries. While ovarian tumors were observed in a total of 6 of the collected samples distributed as, two fibromas, three dermoid cysts, and only one hemangioma. The present study indicates that follicular cysts, luteal cysts and ovarian hypoplasia were the most common ovarian disorders in non-pregnant she-camels in Al-Ahsa region of the Eastern Province of Kingdom of Saudi Arabia.

复发性卵巢癌患者术后血清CA125、D-D水平及残留病灶大小对无瘤生存期的影响

目的 探讨复发性卵巢癌患者术后血清糖链抗原125(CA125)、D-二聚体(D-D)水平及残留病灶大小对无瘤生存期的影响。方法 回顾性分析50例复发性卵巢癌患者的临床资料,随访并记录无瘤生存期。统计患者一般资料及术后血清CA125、D-D水平,分析无瘤生存期影响因素;以Pearson相关系数分析术后CA125、D-D水平及残留病灶大小与无瘤生存期的相关性。结果 不同临床分期、分化程度、化疗疗程、CA125、D-D水平及残留病灶大小的患者无瘤生存期比较,差异有统计学意义(P<0.05);COX回归分析显示,术前临床分期、术后CA125水平、术后D-D水平及术后残留病灶大小是复发性卵巢癌患者无瘤生存期的独立影响因素(P<0.05);Pearson相关性分析显示,术后CA125、D-D水平及残留病灶大小与无瘤生存期均呈负相关(P<0.05)。结论 复发性卵巢癌患者术后CA125、D-D水平及残留病灶大小是影响其无瘤生存期的重要因素。

子宫动脉暂时阻断联合妊娠病灶去除术治疗Ⅱ型及Ⅲ型剖宫产瘢痕妊娠的效果和对卵巢功能的影响

目的评估子宫动脉暂时阻断联合妊娠病灶去除术在治疗Ⅱ型及Ⅲ型剖宫产瘢痕妊娠中的效果,以及该治疗方案对卵巢功能的潜在影响。方法前瞻性选取2020年2月至2023年2月简阳市人民医院收治的Ⅱ型及Ⅲ型剖宫产瘢痕妊娠患者103例,按照随机数字表法将患者分为对照组(n=51)和研究组(n=52)。对照组患者行腹腔镜下妊娠病灶去除术治疗,研究组患者行腹腔镜下子宫动脉暂时阻断联合妊娠病灶去除术治疗。比较两组患者的手术指标(手术时间、术中出血量、住院时间、胚物残留和中转开腹情况)、临床疗效、术后卵巢功能(卵泡刺激素、雌二醇、抗苗勒管激素以及窦卵泡数)和超声检查参数(内膜厚度、搏动指数、阻力指数)情况、术后患者恢复情况(月经恢复正常时间、绒毛膜促性腺激素-β恢复正常时间)及术后并发症发生情况。结果研究组手术时间为(97.15±12.02)min,长于对照组[(90.26±11.45)min],术中出血量和住院时间分别为(90.46±12.45)mL、(7.11±0.98)d,均短于对照组[(118.26±9.46)mL、(8.45±2.16)d],中转开腹率为0,低于对照组(3.85%),差异均有统计学意义(P<0.05);两组患者的胚物残留情况比较,差异无统计学意义(P>0.05)。两组患者的治疗有效率比较,差异无统计学意义(P>0.05)。治疗后3个月,两组的卵泡刺激素、雌二醇、抗苗勒管激素以及窦卵泡数水平等卵巢功能指标比较,差异均无统计学意义(P>0.05)。治疗后3个月,两组的内膜厚度、搏动指数、阻力指数等指标比较,差异均无统计学意义(P>0.05)。两组在月经恢复正常时间、绒毛膜促性腺激素-β恢复正常时间及总并发症发生率方面比较,差异均无统计学意义(P>0.05)。结论与单纯妊娠病灶去除术比较,采用子宫动脉暂时阻断联合妊娠病灶去除术治疗Ⅱ型及Ⅲ型剖宫产瘢痕妊娠手术时间有所延长,但术中出血量及中转开腹率显著降低,对患者的卵巢功能影响较小,术后恢复情况及并发症发生情况与单纯妊娠病灶去除术比较具有相同水平。

达芬奇机器人Xi系统辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变

目的探讨达芬奇机器人Xi系统辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变的效果。方法2020年6月~2023年3月我院行达芬奇机器人Xi系统辅助单孔腹腔镜下卵巢良性病变剔除术13例,采用特制4通道单孔腹腔镜装置,完成达芬奇机器人与患者的对接,使用不带能量的剪刀切开病变卵巢并暴露肿瘤组织,沿肿瘤边缘尽可能完整地剔除肿瘤组织,可吸收线封闭创面后,复原脐部结构。结果13例均通过脐部单一切口完成卵巢良性病变剔除术,无中转开腹。手术时间81~246 min,平均161.4 min。术中出血量5~50 ml,平均21.2 ml。术中发现卵巢扭转2例,卵巢良性病变破裂3例(术后放置引流管)。术后病理:9例成熟畸胎瘤,2例浆液性囊腺瘤,2例单纯性囊肿。术后住院时间2~7 d,平均4.2 d。1例术后切口感染,抗生素治疗后治愈。13例随访6~36个月,平均21.1月,无肿瘤复发,无并发症发生,所有患者脐部切口瘢痕隐匿,且患者及家属对术后外观均满意。结论达芬奇机器人Xi系统辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变安全、可行,可作为一种治疗卵巢良性病变的选择。

传统单孔腹腔镜与机器人辅助单孔腹腔镜手术治疗儿童及青少年卵巢良性病变的疗效比较

目的初步比较第四代达芬奇机器人辅助单孔腹腔镜手术与传统单孔腹腔镜手术治疗儿童及青少年卵巢良性病变的临床效果。方法回顾性分析2018年1月至2023年3月在武汉大学中南医院行第四代达芬奇机器人辅助单孔腹腔镜手术和传统单孔腹腔镜手术的儿童及青少年卵巢良性病变患者临床资料,采取第四代达芬奇机器人辅助单孔腹腔镜手术(robot-assisted laparoscopic single port surgery,R-LESS)13例(R-LESS组),采取传统单孔腹腔镜手术(laparoscopic single port surgery,LESS)22例(LESS组)。统计两组患儿手术时间、术中出血量、卵巢扭转情况、卵巢肿瘤体积、术中有无卵巢肿瘤破裂、是否放置引流管、术后并发症发生率、住院时间、住院费用以及随访情况。结果R-LESS组与LESS组手术时间[161.38(103.00,201.00)min比136.31(100.50,171.50)min]、术中出血量[21.15(10.00,32.50)mL比45.23(10.00,50.00)mL]、卵巢扭转发生率(15%比32%)、术中卵巢肿瘤破裂发生率(23%比36%)、引流管放置率(23%比23%)、术后并发症发生率(8%比6%)以及随访时间[20.70(11.00,29.50)个月比28.09(9.25,46.25)个月]比较,差异均无统计学意义(P>0.05);R-LESS组较LESS组术后住院时间减少[4.23(3.00,5.00)d比5.05(3.75,6.25)d],住院费用增多[(40557.01±4036.29)元比(26456.32±6413.30)元],差异有统计学意义(P<0.05)。结论R-LESS手术治疗儿童及青少年卵巢良性病变安全可行。与LESS手术相比,R-LESS术后患儿恢复更快,但住院费用较高。R-LESS手术可作为治疗儿童及青少年卵巢良性病变的一种选择,未来仍需进行大样本对比研究以进一步验证。

腹腔镜下病灶切除联合子宫动脉阻断术对子宫腺肌病患者NLR、CA125及TGF-β1水平的影响

目的:探讨腹腔镜下病灶切除联合子宫动脉阻断术对子宫腺肌病患者中性粒细胞-淋巴细胞比值(NLR)、糖类抗原125(CA125)及转化生长因子1(TGF-β1)水平的影响。方法:收集2020年9月-2023年8月本院的子宫腺肌病患者210例并随机分为对照组(105例,腹腔镜下病灶切除术)和观察组(105例,腹腔镜下病灶切除联合子宫动脉阻断术),比较两组手术时长、术中失血量,术前术后第6个月月经量、疼痛、子宫体积、卵巢功能、NLR、CA125及TGF-β1。结果:观察组术中失血量(276±35ml)、手术时长(87±25min)均低于对照组(357±26ml、115±36 min),术后6个月月经量(12.44±2.14片/月)、疼痛VAS评分(2.06±0.62分)、子宫体积(89.47±14.25 cm3)、NLR(2.06±0.86)、CA125(20.35±2.71 KU/L)、TGF-β1(35.98±8.12 mg/L)均低于对照组(15.63±1.56片/月、2.45±0.78分、95.36±12.36 cm^(3)、2.45±0.95、24.53±2.48 KU/L、42.63±8.56 mg/L);术后1周,观察组雌二醇水平(159.36±24.71 pg/ml)低于对照组(168.47±27.06 pg/ml),黄体生成素(11.59±3.18 U/L)和卵泡刺激素(27.56±3.84 U/L)高于对照组(10.57±2.87 U/L、26.51±3.49 U/L)(均P<0.05)。术后6个月,两组性激素水平无差异,无1例复发。结论:腹腔镜下病灶切除术和腹腔镜下病灶切除联合子宫动脉阻断术均可治疗子宫腺肌病,腹腔镜下病灶切除联合子宫动脉阻断术在提高手术效率、改善痛经症状及降低NLR、CA125及TGF-β1水平,对卵巢功能的影响更优。

超声诊断卵巢囊肿性病变特征性表现及其应用价值研究

目的:分析卵巢囊肿性病变患者接受超声诊断的效果。方法:2021年1月-2023年1月期间因卵巢囊肿型病变入院的患者内抽取50例,对其实施超声检查,将病理学结果作为金标准,分析检查的准确性、超声特征性表现。结果:50例卵巢囊肿性病变患者经超声检查,其诊断符合率为98%(49/50),误诊率为2%(1/50),P>0.05。结论:可根据超声检查结果对患者进行初步判断,辅以其他检查明确诊断,随后对患者实施治疗。

荧光显影技术辅助腹腔镜子宫内膜异位病灶切除术治疗子宫内膜异位症患者的效果

目的:观察荧光显影技术辅助腹腔镜子宫内膜异位病灶切除术治疗子宫内膜异位症(EMT)患者的效果。方法:选取2020年2月至2023年2月该院收治的82例EMT患者进行前瞻性研究,根据随机数字表法将其分为对照组和观察组各41例。对照组采用腹腔镜子宫内膜异位病灶切除术治疗,观察组采用荧光显影技术辅助腹腔镜子宫内膜异位病灶切除术治疗,比较两组围术期指标水平,手术前后应激指标[缓激肽(BK)、去甲肾上腺素(NE)、皮质醇(Cor)]水平、卵巢功能指标[卵泡刺激素(FSH)、促黄体生成素(LH)、抗米勒管激素(AMH)、窦卵泡数目(AFC)]水平,临床疗效和术后1个月内并发症发生率。结果:观察组手术时间、住院时间均短于对照组,术中出血量少于对照组,子宫内膜剥除厚度小于对照组,差异有统计学意义(P<0.05);术后3 d,两组血清BK、NE、Cor水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后3个月,两组FSH、LH水平均低于术前,AMH水平均高于术前,AFC均多于术前,但组间比较,差异均无统计学意义(P>0.05);两组治疗总有效率和并发症发生率比较,差异均无统计学意义(P>0.05)。结论:荧光显影技术辅助腹腔镜子宫内膜异位病灶切除术治疗EMT患者可降低围术期指标水平和应激指标水平,效果优于腹腔镜子宫内膜异位病灶切除术治疗。

高弥散敏感因子的弥散加权成像及动态增强磁共振成像联合肿瘤糖类抗原125对早期卵巢病变性质判断能力的研究

目的:研究高弥散敏感因子(高b值)弥散加权成像(DWI)、动态增强磁共振成像(DCE-MRI)结合肿瘤糖类抗原125(CA125)对卵巢病变性质判断的临床效果。方法:选取2020年4月至2022年4月南通市海门区人民医院经治的100例卵巢病变患者进行回顾性研究,所有患者均行CA125、DWI、DCE-MRI检查及病理检查定性,按病理结果将58例卵巢恶性病变患者纳入恶性组,42例卵巢良性病变患者纳入良性组,分析比较两组患者的CA125情况,以及高b值DWI+CA125、DCE-MRI+CA125和高b值DWI+DCE-MRI+CA125不同检查方法的受试者工作特征曲线(ROC)结果。结果:恶性组CA125水平明显高于良性组,差异有统计学意义(t=29.357,P<0.05);CA125阳性率显著优于良性组,差异有统计学意义(x2=34.456,P<0.05),恶性组表观弥散系数(ADC)值为(0.91±0.18)×10^(3)mm^(2)/s明显小于良性组(ADC=33±0.21×10^(3)mm^(2)/s),而对比剂容积转换常数(Ktrans)、速率常数(Kep)及血管外细胞外间隙容积比(Ve)指标明显高于良性组,差异均有统计学意义(t=16.863、9.686、10.205,P<0.05);高b值DWI+DCE-MRI+CA125检查方法诊断恶性卵巢肿瘤的准确率、灵敏度、阴性预测值及阳性预测值均高于高b值DWI+CA125或DCE-MRI+CA125检查方法。DCE-MRI+CA125与高b值DWI+CA125检查方法的各指标比较,差异无统计学意义(P>0.05);ROC曲线分析显示,高b值DWI+DCE-MRI+CA125检查方法的ROC曲线下面积(AUC)最佳(AUC=0.920)。结论:高b值DWI+DCE-MRI+CA125的组合检查方法总体诊断效能较好,可提升恶性卵巢肿瘤的临床诊断筛查能力,具有一定的临床应用价值。

彩超图像及血流频谱特征在异位妊娠病灶破裂、卵巢黄体破裂中的鉴别诊断价值研究

目的 研究彩超图像及血流频谱特征在异位妊娠病灶破裂、卵巢黄体破裂中的鉴别诊断价值。方法 回顾性分析2019年1月至2022年12月于河南省生殖妇产医院检查的102例患者,其中46例异位妊娠病灶破裂患者为异位妊娠病灶破裂组,56例卵巢黄体破裂患者为卵巢黄体破裂组,观察两组患者彩超图像特征差异,比较两组患者血流频谱特征[阻力指数(RI)、搏动指数(PI)、收缩期峰值流速(PSV)]、卵巢体积和液性暗区深度。以受试者工作曲线(ROC)分析RI、PI、PSV、卵巢体积、液性暗区深度联合鉴别诊断异位妊娠病灶破裂、卵巢黄体破裂的价值。结果 彩超图像中,异位妊娠病灶破裂组中部分可见胎芽、假性妊娠囊,血流表现以“点状”“条状”为主,血流频谱特征多样。卵巢黄体破裂组血流表现以“半环状/环状”为主,血流频谱特征以极低/低阻力型为主。血流频谱特征中,异位妊娠病灶破裂组RI、PI显著高于卵巢黄体破裂组,差异均有统计学意义(P <0.05);异位妊娠病灶破裂组PSV、卵巢体积、液性暗区深度显著低于卵巢黄体破裂组,差异均有统计学意义(P <0.05)。RI、PI、PSV、卵巢体积、液性暗区深度水平联合鉴别诊断异位妊娠病灶破裂、卵巢黄体破裂的曲线下面积(AUC)为0.866,灵敏度为84.87%,特异度为76.79%。结论 彩超下异位妊娠病灶破裂、卵巢黄体破裂图像特征及血流频谱特征存在明显差异,为临床鉴别诊断提供依据。

常规MRI及DCE-MRI在卵巢肿瘤及肿瘤样病变诊断中的应用

目的:提高常规MRI及DCE-MRI在卵巢肿瘤及肿瘤样病变的诊断准确率。方法:回顾性分析44例我院收治并经手术病理证实为卵巢肿瘤及肿瘤样病变的常规MRI及DCE-MRI影像表现。平扫参考指标:病灶大小(最大径)、形状(规则/不规则)、有无包膜、囊壁/分隔厚度、实性成分比例、T2WI信号、ADC值、盆腔积液;DCE-MRI参考Ktrans、Kep以及Ve值。结果:MRI平扫显示良、恶性肿瘤的病灶大小、形状、实性成分比例、囊壁/分隔厚度、T2WI信号混杂程度、盆腔积液量及ADC值差异有统计学意义(P<0.05);上述7项中ADC值参考价值最大,ADC取1.09×10^-3)mm^2/s为良恶性肿瘤阈值,小于阈值,考虑恶性。DEC-MRI良性肿瘤实性部分Ktrans、Kep以及Ve值显著低于恶性肿瘤,差异有统计学意义(P<0.05),Ktrans值参考价值最大,Ktrans值取0.091/min为良恶性肿瘤阈值,大于阈值,考虑恶性。分别以ADC值及Ktrans值敏感度、特异性、准确度、阳性预测值及阴性预测值代表MRI平扫及DCE-MRI各项指标,得出常规MRI敏感度85.7%、特异性91.3%、准确度88.6%、阳性预测值90.0%、阴性预测值87.5%;DCE-MRI上述各项指标为72.7%、81.8%、77.3%、80.0%、75.0%;常规MRI联合DCE-MRI检查敏感度95.2%,特异性100.0%,准确度97.7%,阳性预测值100.0%,阴性预测值95.8%。结论:常规MRI联合DCE-MRI用于卵巢肿瘤及肿瘤样疾病诊断及鉴别诊断能够提高诊断准确率。

45例妊娠合并卵巢肿瘤及瘤样病变的临床诊治体会

摘要：目的探讨妊娠合并卵巢肿瘤及瘤样病变的临床特点和诊疗方法，寻找合理化治疗方法。方法回顾性分析该院2005年1月-2012年1月收治的45例妊娠合并卵巢肿瘤及瘤样病变患者的临床、手术和病理资料。结果妊娠合并良性卵巢肿瘤33例，瘤样病变9例，交界性黏液性囊腺瘤2例，浆液性囊腺癌1例。孕早期超声诊断20例，占44．4％（20／45），孕中期超声诊断9例，占20．o％（9／45），剖宫产中发现6例，占13-3％（6／45），并发症手术的有10例，占20．0％（9／45），其中蒂扭转7例（7／45，15．6％），破裂2例（2／45，4．4％），恶变1例（1／45，2．2％）。手术方式：患侧剥除35例，附件切除8例，卵巢癌肿瘤细胞减灭术1例。结论妊娠合并卵巢肿瘤大部分为良性肿瘤，应警惕瘤样病变过度治疗，孕早期超声检查对妊娠合并卵巢肿瘤的诊断有重要意义，选择合适的手术时机和治疗方法可获得最佳的妊娠结局。

卵巢肿瘤和肿瘤样病变的CT诊断

目的 :分析卵巢肿瘤的CT表现 ,提高CT诊断卵巢肿瘤的准确性。材料和方法 :分析我院经手术病理证实的 5 3例卵巢肿瘤 (其中良性 2 2例 ,恶性 2 5例 )与 6例肿瘤样病变的CT表现。结果 :良性卵巢肿瘤CT检出 2 1例 (检出率为95 .5 % ) ,术前CT诊断为良性肿瘤 19例 (准确率 86.4% ) ;CT检出恶性肿瘤 2 2例 (检出率 88% )。术前CT诊断恶性 2 0例(准确率 80 % ) ;肿瘤样病变 6例 ,CT全部检出 ;所有的病例 ,CT检出率为 92 .5 % ,良恶性定性准确率为 84.9%。结论 :CT能清晰显示盆腔结构 ,可提供对肿瘤的定位、定性、病变范围的可靠信息。

MR扩散加权成像对卵巢病变定性诊断的研究

目的探讨扩散加权像(DWI)对卵巢病变的鉴别诊断价值。资料与方法73例81个病理证实的卵巢病变术前行常规MRI和DWI。比较不同性质病变囊性部分及实性部分间表观扩散系数(ADC)值及指数表观扩散系数(eADC)值差异。结果良、恶性卵巢肿瘤间囊性部分ADC值和eADC值的鉴别诊断阈值分别为2.755×10-3mm2/s和6.455×10-2,而实性部分ADC值和eADC值的最佳阈值分别为1.195×10-3mm2/s和29.55×10-2。结论DWIADC值和eADC值有助于卵巢良、恶性肿瘤的鉴别诊断。

3.0T MR在卵巢肿瘤诊断中的临床应用价值

目的分析3.0T MR鉴别诊断卵巢肿瘤患者的临床结果。方法对2012年5月至2015年5月我院收治的40例卵巢肿瘤患者的临床资料进行回顾性分析。结果40例患者中,37例患者的鉴别诊断符合手术病理结果,达到了92.5%的临床诊断符合率;15例患者为单纯性卵巢囊肿,8例患者为卵巢囊性畸胎瘤,6例患者为卵巢囊腺瘤,5例患者为卵巢子宫内膜异位囊肿,3例患者为卵巢囊腺癌,3例患者为卵巢冠囊肿,分别占总数的37.5%、20.0%、15.0%、12.5%、7.5%、7.5%。卵巢囊性畸胎瘤、黏液性囊腺瘤、浆液性囊腺瘤、卵巢冠囊肿的平均瘤体/囊肿直径分别为(12.5±3.3)cm、(10.5±3.5)cm、(10.2±3.3)cm、(14.3±3.4)cm。结论 MR能够有效鉴别诊断卵巢肿瘤。