输卵管积液的CT和MRI表现及误诊分析

发布时间：2018-09-14 09:16

【摘要】：目的探讨输卵管积液的CT及MRI影像学特点,并与病理结果对照以提高对该病的认识。方法回顾性分析30例输卵管积液患者的CT、MRI表现,观察、分析病变部位、病灶的形态及边界、CT密度及MRI信号、病灶增强后的强化模式等指标。记录输卵管积液患者的发病年龄、合并症及CT和/或MRI诊断结果,并进行分组,应用χ2检验,对漏误诊情况加以分析。结果双侧发病15例,单侧发病15例,共有45个病灶。22例(73.3%)合并卵巢及子宫其他疾病,其中合并卵巢囊肿12例,子宫肌瘤7例,其他病变6例,同时合并卵巢囊肿及子宫肌瘤3例。附件区病变在CT及MRI上表现为囊性、囊实性及境界不清晰肿块分别为36个(80%)、8个(17.8%)、1个(2.2%);病灶外观呈腊肠样、单囊、多囊及其他形态者分别为26个(57.8%)、11个(24.4%)、7个(15.6%)、1个(2.2%)。CT平扫31个病灶多表现为腊肠样(45.2%)、单囊样(32.2%)、多囊样(19.4%)低、略低及等密度肿块影,边界清晰,1个(3.2%)病灶呈其他形态;MRI扫描输卵管积液T1WI呈低信号(86.7%)或等信号(13.3%),T2WI呈高信号(100%),DWI呈低信号(86.7%)或高信号(13.3%);增强扫描除1个病灶未见强化外,其余44个病灶均显示为囊(管)壁强化,囊(管)内液体无强化。45个病灶共漏误诊26个,腊肠样低密度肿块者漏误诊率为34.6%,单囊者漏误诊率为81.8%,多囊者漏误诊率为100%,单囊及多囊者的漏误诊率明显高于腊肠型(χ2=10.65,P0.01)。结论输卵管积液好发于中年女性,合并症多;其常见的CT及MRI特征为腊肠样、单囊及多囊样的水样密度或信号灶,囊液不强化而囊壁呈薄壁强化。腊肠样改变易被正确诊断,但单囊、多囊及囊实性者容易漏误诊。
[Abstract]:Objective to investigate the imaging features of fallopian tube effusion by CT and MRI, and to improve the understanding of the disease. Methods the CT,MRI findings of 30 cases of fallopian tube effusion were retrospectively analyzed. The location of lesion, the shape and boundary of the lesion, the CT density and MRI signal, and the enhancement pattern after enhancement were analyzed. The age of onset, complications, CT and / or MRI diagnosis of the patients with fallopian tube effusion were recorded and divided into groups. The misdiagnosis of leakage was analyzed by 蠂 2 test. Results 15 cases were bilateral and 15 cases were unilateral. There were 45 lesions. 22 cases (73.3%) were complicated with ovarian and other diseases, including 12 cases of ovarian cyst, 7 cases of uterine leiomyoma and 6 cases of other diseases. There were 3 cases of ovarian cyst and hysteromyoma at the same time. The lesions in the adnexal region were cystic on CT and MRI, with 36 (80%) solid masses, 8 (17.8%) masses and 1 (2.2%) lesions with a single cyst. There were 26 (57.8%) polycystic lesions, 11 (24.4%) polycystic lesions, 7 (15.6%), 1 (2.2%) plain CT scans, 31 lesions with sausage like (45.2%), single cysts (32.2%), multiple cysts (19.4%), and slightly lower density masses. The boundary was clear, and one (3.2%) lesions showed hypointensity (86.7%) or isointense (13.3%) on T1WI of tubal effusion, and the enhancement scan showed hypointensity (86.7%) or hyperintense (13.3%) on T2WI, and no enhancement was found in 1 lesion. The other 44 lesions showed enhancement of the wall of the capsule (tube), no enhancement of the fluid in the cyst (tube), and 26 misdiagnoses in 45 lesions. The misdiagnosis rate was 34.6% in the patients with low density lumps of sausage, 81.8% in the patients with single cyst and 100% in the patients with polycystic tumors. The misdiagnosis rate of the patients with single cyst and polycystic type was significantly higher than that of the type of sausage (蠂 2 10. 65% P0.01). Conclusion the effusion of fallopian tube is more common in middle aged women than in middle aged women, and the common CT and MRI features are sausage, water density or signal foci of single or polycystic. The cyst fluid is not enhanced and the wall of the capsule is enhanced with thin wall. Dachshund changes are easy to be correctly diagnosed, but single, polycystic and cystic sex patients are prone to misdiagnosis.
【作者单位】：南京中医药大学附属医院放射科;南京中医药大学附属医院病理科;泰山医学院放射学院;
【分类号】：R711.76;R445.2;R816.91

【参考文献】