胎儿卵巢囊肿蒂扭转的产前产后超声诊断分析

目的探讨胎儿卵巢囊肿蒂扭转的产前及产后声像图特征,以提高该病的早期诊断率。方法选取经产后确诊的51例胎儿期卵巢囊肿,其中18例卵巢囊肿未扭转,33例卵巢囊肿蒂扭转,对两者胎儿期及婴儿期超声声像图特征进行对比分析。结果 18例卵巢囊肿未扭转病例中产后囊肿大小改变15例(83.33%),位置改变4例(22.22%),内部回声改变2例(11.11%);33例卵巢囊肿扭转病例中产后大小改变30例(90.91%),位置改变9例(27.27%),内部回声改变28例(84.85%),两组病例间大小及位置的改变差异无统计学意义,而内部回声改变的差异有统计学意义。结论相比于囊肿大小和位置的改变,产前及产后囊肿内部回声的改变对于卵巢囊肿蒂扭转的诊断更具有意义,因此产前产后对囊肿内部回声的定期随访至关重要。     

胎儿卵巢囊肿产前超声图像特点及预后评估

目的探讨胎儿卵巢囊肿产前超声声像图特点及预后评估。 方法对2015年1月至2019年12月北京市海淀区妇幼保健院产前超声诊断的19例胎儿卵巢囊肿检出时的胎龄、大小及回声变化特点进行回顾性分析,总结其预后。 结果12例单纯型囊肿和4例复杂型囊肿大小变化符合缩小趋势。18例胎儿卵巢囊肿长径均在30~33周达到最大值。除1例复杂型胎儿卵巢囊肿发生蒂扭转出生后切除外,14例单纯型囊肿和4例复杂型囊肿产前或出生后1年内均自行消退。 结论产前超声监测胎儿卵巢囊肿大小及回声改变是围产期预后的主要决定因素,可为指导产前管理和预测生后结局提供确切依据。     

胎儿卵巢囊肿蒂扭转产前超声诊断及临床预后分析

目的 探讨产前超声诊断胎儿卵巢囊肿蒂扭转的临床价值。方法　回顾性分析超声诊断为胎儿卵巢囊肿蒂扭转7例胎儿期超声图像,随访新生儿出生后情况,分析胎儿卵巢囊肿蒂扭转超声特征及早期诊断意义。结果 7例中6例产后证实为卵巢囊肿蒂扭转,1例术后证实为阴道闭锁,为误诊病例,余6例囊肿分娩前均表现为复杂性囊肿,6例直径大于4cm,1例直径小于4cm,超声诊断胎儿卵巢囊肿蒂扭转的准确性为85.7%。结论 产前超声能够明确胎儿卵巢囊肿蒂扭转,具有重要的临床价值,复杂囊肿并囊肿直径大于4cm是产前超声诊断胎儿蒂扭转的关键指标。     

新生儿及婴儿期卵巢复杂型囊肿超声图像特征与手术病理对照

目的 总结新生儿及婴儿期卵巢复杂型囊肿超声图像特征,提高超声对该病转归的预判能力。方法 对17例女婴卵巢复杂型囊肿进行超声图像分析及手术病理随访。结果 17例女婴(年龄1 d～9个月)胎儿期产前超声均发现腹腔或盆腔囊性肿物,生后复查均提示卵巢复杂型囊肿,其中1例分别于出生后2个月、9个月复查,两次超声图像特征不同。卵巢复杂型囊肿超声图像表现为囊内液体-碎片分层征14例,中等回声团块(回缩块)4例,囊壁厚薄不均呈双层膜状12例,囊壁钙化16例。经同期手术证实囊肿内均有暗红色陈旧性出血,其中位于右卵巢10例,左卵巢7例。卵巢囊肿蒂扭转坏死10例,其中6例扭转360°,4例发生自截脱落腹盆腔呈游离状态。病理均为卵巢囊肿出血坏死并囊壁钙化。结论 新生儿及婴儿期卵巢复杂型囊肿的超声图像特征为囊内液体-碎片分层征,中等回声团块(回缩块),囊壁厚薄不均匀呈双层膜状,囊壁散在或簇状钙化,上述图像特征高度提示女婴卵巢囊肿内出血坏死、囊壁钙化及蒂扭转的可能性,需要外科手术及时干预。     

胎儿卵巢囊肿的产前超声诊断及预后评估

目的通过分析女性胎儿卵巢囊肿的声像图特点及临床转归,探讨产前超声的诊断价值及临床意义。方法收集胎儿卵巢囊肿的病例92例,分析声像图特征、出生后变化、干预结果等资料,总结预后与转归。结果 92例病例中失访5例,最终87例纳入本研究。其中74例(85.1%)自行消退,13例(14.9%)患儿出生后手术治疗。病理结果为卵巢单纯型囊肿5例(38.5%),一侧卵巢囊肿蒂扭转3例(23.1%),良性畸胎瘤5例(38.5%)。结论胎儿期卵巢囊肿可通过超声检出,多数可自行消退,预后良好;若囊肿50mm,建议进行产前穿刺吸引或出生后手术治疗。     

新生儿及婴儿期卵巢囊肿蒂扭转的超声表现

目的总结新生儿及婴儿卵巢囊肿蒂扭转的超声声像图特征。 方法对2006年1月至2016年12月在首都医科大学附属北京儿童医院就诊,经手术及病理检查诊断为卵巢囊肿83例（84个囊肿）患儿的超声图像表现进行总结。 结果术前超声声像图示84个卵巢囊性肿物中51个囊肿内含液体-碎片分层及和（或）回缩块,诊断为复杂型囊肿（46个手术及病理诊断为卵巢囊肿蒂扭转,其余5个为未扭转的卵巢囊肿）;33个术前超声无囊内出血改变,诊断为单纯性囊肿（7个手术及病理诊断为卵巢囊肿蒂扭转,其余26个为未扭转的卵巢囊肿）。 结论囊内液体-碎片分层及回缩块可作为诊断卵巢囊肿蒂扭转的重要间接征象。囊内液体-碎片分层及回缩块对诊断卵巢囊肿蒂扭转有临床价值。     

胎儿卵巢囊肿的产前超声诊断价值

目的利用产前超声检查女性胎儿盆腔囊性病变,探讨产前超声诊断卵巢囊肿的价值。方法对超声诊断胎儿盆腔囊性病变病例21例进行回顾性研究,分析其声像图特点、胎儿出生后病变的变化及转归。结果 21例患儿产前超声诊断盆腔囊性病变,病变最大直径19～39mm,平均24mm,其中单纯卵巢囊肿型17例,复杂卵巢囊肿型2例,单纯性肾脏囊肿2例于产后新生儿复查证实。17例单纯型卵巢囊肿均在产后90d内自然消退,2例复杂性卵巢囊肿在120d内自然消退。结论产前超声检查有助于明确盆腔囊性病变的性质和来源,是诊断女性胎儿卵巢囊肿的首选影像学方法。     

超声诊断卵巢囊肿蒂扭转合并输卵管囊肿1例

患者女,14岁。体质量105kg。因剧烈腹痛1d行超声检查。B超所见:于脐下约2cm处可见20.1cm×8.9cm无回声区,呈“∞”形,内透声不良,可见密集光点(图1)。子宫大小正常,肌层回声均匀,宫图1卵巢囊肿蒂扭转合并输卵管囊肿声像图腔线清晰。超声诊断:下腹部囊性包块(卵巢囊肿蒂扭转可能性大)。术中见左侧卵巢囊肿大小约为10cm×5cm×5cm,其蒂部扭转3周,左侧卵巢及输卵管均已坏死,呈紫黑色;右侧卵巢大小约为7cm×4cm×3cm,包膜增厚,其内可见多个囊性卵泡,右输卵管囊肿大小10cm×4cm×5cm。讨论卵巢囊肿蒂扭转是妇产科的急腹症之一,超声工作者习惯用…     

胎儿鼻泪管囊肿的产前超声诊断

目的 探讨胎儿鼻泪管囊肿的产前二维及三维超声声像图特征.方法 采用二维及三维超声对29例鼻泪管囊肿胎儿行产前连续顺序超声检查,重点对双侧眼眶横切面超声图像特征进行观察,并与引产及产后临床随访结果进行比较,总结鼻泪管囊肿产前超声声像图特征.结果 胎儿鼻泪管囊肿主要声像图特征是眼眶鼻侧下方呈类圆形无回声区,内径<15 mm,边界清,壁较光滑,内透声好.29例鼻泪管囊肿胎儿产前超声表现:二维超声显示单侧鼻泪管囊肿22例(左侧12例,右侧10例),双侧鼻泪管囊肿7例;囊肿大小4～13 mm,平均(7.69±2.25) mm.囊肿边界清,壁较光滑,内透声好;其中20例眼眶鼻侧下方呈类圆形无回声区,9例内分泌物沉积囊内形成稍高回声团.CDFI:29例鼻泪管囊肿内均未见明显彩色血流信号.三维超声均可直观显示29例鼻泪管囊肿,表现为眼眶鼻侧囊性无回声区及眼眶鼻侧皮肤局部隆起.产前超声诊断胎儿鼻泪管囊肿28例(28/29),误诊1例(产前二维超声诊断为鼻泪管囊肿,出生后证实为眼眶皮样囊肿).29例胎儿临床复查和产后随访结果:(1)孕31～36周超声复查4例胎儿鼻泪管囊肿消失.(2)2例引产儿中1例鼻泪管囊肿合并室间隔缺损及脐动脉腹内段走行异常,1例鼻泪管囊肿合并唇腭裂.(3)19例(19/29)出生后可见鼻泪管囊肿,囊肿部位及侧别与产前超声检查结果相符合.结论 产前二维及三维超声能较好显示胎儿鼻泪管囊肿,并能动态监测其转归,是诊断胎儿鼻泪管囊肿首选方法.     

胎儿肾上腺囊性病变的超声观察

目的 评价胎儿肾上腺囊性病变的超声诊断价值.方法 回顾性分析我院21例产后经手术或穿刺活检证实的胎儿期肾上腺囊性病变的超声影像资料,并与产后新生儿期超声随访资料进行比较.结果 21例胎儿期肾上腺囊性病变,超声表现无回声15例,斑片状混合回声6例;产后新生儿期无回声10例,混合回声11例;产后病理证实单纯性囊肿10例.囊肿内出血5例,自发性肾上腺出血6例.结论 胎儿期肾上腺囊性病变的声像图特征可以为临床产前诊断该类疾病提供有意义的诊断信息.     

彩色多普勒超声诊断卵巢囊肿蒂扭转的临床价值

目的探究彩色多普勒超声(CDFI)诊断卵巢囊肿蒂扭转的临床价值,以期为临床治疗提供参考依据。方法以2017年2月至2020年2月46例收治的疑似卵巢囊肿蒂扭转患者作为研究对象,患者均接受CDFI以及病理检查,并对检查结果进行分析。结果46例疑似卵巢囊肿蒂扭转患者的麻花状绳状、血管蒂类型检出率为47.83%,盆腔游离液性暗区检出率为52.17%,囊肿直径≤8 cm的检出率为78.26%,囊壁厚度>0.85 cm检出率为50.00%,囊性肿块检出率为80.43%。疑似卵巢囊肿蒂扭转患者经CDFI检查的卵巢黏液性腺囊瘤、卵巢浆液囊腺瘤、卵巢囊性畸胎瘤、卵巢黄体囊肿、卵巢巧克力囊肿、单纯卵巢囊肿检出率与病理诊断结果比较,差异无统计学意义(P>0.05)。CDFI诊断卵巢囊肿蒂扭转的灵敏度为90.91%,特异度为100.00%,准确度为91.30%。结论CDFI应用在卵巢囊肿蒂扭转患者的诊断中,有着较高的灵敏度、特异度、准确度,可较好地检出疾病,且可鉴别诊断疾病的具体类型,为患者疾病的确诊以及治疗方案的制定提供参考依据。     

Prenatal diagnosis and management of a massive fetal ovarian hemorrhagic cyst torsion with secondary fetal anemia

We report the case of one of the largest prenatally detected fetal hemorrhagic cyst with ovarian torsion and fetal anemia leading to subsequent cesarean section delivery and further unilateral oophorectomy of the neonate. Usually, fetal ovarian cysts tend to resolve spontaneously within the first months after birth. There is no need of surgical treatment for such simple cysts. Routine sonographic examinations are obligatory, because in some cases complications such as massive hemorrhage, cyst rupture, or ovarian torsion with following infarction can occur. With the occurrence of these complex cyst signs by sonographic investigation, subsequent intervention should be considered by an interdisciplinary team. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound 42:219–222, 2014     

卵巢黄体囊肿破裂75 例临床分析

目的：探讨卵巢黄体囊肿破裂的临床特征和治疗方案。方法：对75例卵巢黄体囊肿破裂临床资料进行回顾性分析。结果：75例均发生于卵巢功能旺盛时期,均以突发性下腹痛为主要症状,5l例以右下腹痛为主,43例伴阴道流血,后穹隆穿刺或腹腔穿刺均抽出不凝血液。入院诊断为黄体囊肿破裂65例,腹痛原因待查10例。73例经手术病理证实为黄体囊肿破裂;2例经临床分析诊断为卵巢黄体囊肿破裂,保守治疗而愈。结论：卵巢黄体囊肿破裂既可发生于月经黄体,又发生于妊娠黄体,以右侧卵巢多见,临床应注意与阑尾炎、异位妊娠破裂及卵巢肿瘤蒂扭转鉴别。     

彩色多普勒超声诊断卵巢扭转的价值

目的探讨彩色多普勒超声(CDFI)对卵巢扭转的诊断价值。方法应用CDFI对经手术后病理证实的11例卵巢扭转的声像图进行综合分析。结果3例为单纯性卵巢扭转,超声均准确诊断。8例为卵巢肿物伴扭转,超声准确提示扭转6例,2例分别误诊为右卵巢囊肿伴感染及左黄体血肿伴感染。诊断符合率81.8%。结论彩色多普超声诊断卵巢扭转实用有效,寻找并识别扭转的血管蒂是诊断本病的关键。     

卵巢肿瘤扭转的CT表现

目的探讨卵巢肿瘤扭转的CT表现.方法回顾分析经手术病理证实的15例卵巢肿瘤扭转的CT资料.结果 16个扭转肿瘤平均最大径10.7 cm.14个为囊性或囊实性、2个为实性.囊壁向心性增厚7例、偏心性增厚3例.输卵管增粗7例.5例输卵管、8例囊性肿瘤囊壁和2例实性肿瘤平扫CT值大于50 Hu,增强扫描后没有强化,手术证实有出血性梗死.6例有少量腹水及肿瘤周围脂肪密度增高.子宫偏向扭转侧9例.结论卵巢肿瘤扭转的CT表现有一定特征.CT在诊断卵巢肿瘤扭转上有价值.     

Fetal ovarian cysts: a report of three cases managed by intrauterine aspiration.

Small follicular or functional theca-lutein cysts are a common finding in fetal and neonatal ovaries. After delivery, decrease of hormonal stimulation may lead to spontaneous resolution of the cyst. A high rate of complication has been underlined by recent studies, the most common being ovarian torsion with subsequent loss of the ovary. Because torsion may happen with any size of cyst, however large or small, we suggest in utero decompression even in small fetal ovarian cysts (< 5 cm). We report here three cases of such cysts managed by intrauterine aspiration with good outcome and no further need for neonatal surgery. In all cases cytology of the cyst aspirate demonstrated numbers of granulosa cells and fluid biochemistry showed a high amount of estradiol, progesterone, and testosterone that confirmed the etiology as ovarian. Despite the small size of the cysts, no technical difficulties were encountered and no maternal or fetal morbidity occurred. Prenatal management of fetal ovarian cysts remains controversial, however, and our limited experience needs to be assessed on a larger number of cases.     

A case of uterine torsion concurrent with a ruptured ovarian endometrial cyst

The patient was a 54-year-old female presented with severe abdominal swelling and intermittent pain. On emergent CT, massive ascites with thickened peritoneum and intra-pelvic cystic mass approximately 20 cm in diameter were observed. The cyst wall showed redundant irregular shape. The uterus was enlarged with intramural mass located at its right anterior fundus. MRI showed this pelvic cyst as high intensity on T1-weighted images, so that it was suspected as an endometrial cyst. The operation revealed the rupture of endometrial cyst and the uterine torsion of 180° around the long axis. Retrospectively, the X-shaped configuration of the upper vagina was observed on MRI and both the adnexa, including right ovarian cyst, were connected to the opposite side ovarian vein. Torsion of a non-gravid uterus is rare. In this case, the uterine torsion seemed to be caused by enlarged uterine body and ruptured endometrial cyst. Radiologists should be aware of this potential complication of huge ovarian mass and enlarged uterus and its appearance.