卵巢囊性病变的CT诊断

目的 提高CT诊断卵巢囊性病变的正确性。材料与方法 搜集经手术和病理证实的121例共161个卵巢区囊性病变,对其CT表现作回顾性分析。结果 161个病灶中,良性102例134个病灶,恶性19例27个病灶,120个为完全囊性,41个有囊壁结节或实性部分,分别占74.5%和25.5%,其中囊性畸胎瘤21例25个病灶,囊腺瘤18例,均为单个病灶,囊腺癌7例12个病灶,Krukenberg瘤5例7个病灶,内膜异位囊肿31例39个病灶,黄体囊肿8例9个病灶,滤泡囊肿8例9个病灶,浆液或粘液性囊肿11例,中肾管囊肿10例,陈旧性异位妊娠4例,卵巢输卵管脓肿,炎症积水9例13个病灶,其他4例,术前CT诊断准确庞81.8%。结论 卵巢囊性病变种类较多,基本CT表现多类似,但良性病变常为圆形或卵圆形,囊壁薄而规则;恶性病变多为双侧不规则形,囊壁及囊内分隔厚而不规则,结节状,CT在卵巢囊性病变的诊断中有较高价值。

CT Diagnosis of Ovarian Cystic Lesions

Objective To improve the diagnostic accuracy of ovarian cystic lesions with CT scan.Materials and Methods CT findings of 121 patients with 161 surgically and pathologically proved ovarian cystic lesions were retrospectively analyzed.Results Of 161 lesions, 134 were benign (in 102 cases) and 27 were malignant (in 19 cases). 120 lesions were entirely cystic and 41 carried nodules on the cystic wall (74.5%) or solid components (25.5%). The 161 lesions included following diseases: cystic teratoma (n=25, 21 cases), cystadenoma (n=18, 18 cases), cystadenocarcinoma (n=12, 7 cases), Krukenberg tumor (n=7, 5 cases), endometrial cyst (n=39, 31 cases), corpus luteum cyst (n=9, 8 cases), follicle cyst (n=9, 8 cases), serious or mucous cyst (n=11), Wolffian cyst (n=10), chronic ectopic pregnancy (n=4), tuboovarian abscess or hydrosalpinx (n=13, 9 cases), and miscellaneous (n=4). The total accuracy of preoperative diagnosis was 81.8%. Conclusion The ovarian cystic lesions has a wide spectrum, which has similar CT signs. Benign cystic lesions are usually round or oval in shape with a thin and even wall. Malignant cystic lesions are usually bilateral, irregular in shape, with thick and irregular wall or septa. CT scan is a valuable means for the diagnosis of ovarian cystic lesions.