输卵管与卵巢脓肿的SCT及MR诊断

目的探讨输卵管脓肿(FTA)、输卵管卵巢脓肿(TOA)的CT和MR诊断价值。方法回顾分析20例经手术及病理证实的单纯输卵管脓肿、输卵管卵巢脓肿的CT和MR扫描资料,16例行CT扫描,4例行MR检查。结果单纯输卵管脓肿6例,CT表现附件区管状囊性肿块4例和输卵管增粗2例,管腔内可见小分隔、积脓,管壁增厚且明显强化。输卵管卵巢脓肿14例,表现为附件区厚壁多房囊实性肿块,边界不清,CT平扫呈等低混杂密度,MRT1WI呈低信号,T2WI呈高信号,信号不均匀,增强扫描脓肿实性部分、囊壁及分隔明显均匀强化,囊性区无强化。继发征象包括脓肿周围条索及网格状影5例,与子宫体粘连分界不清12例,输卵管系膜增厚8例;直肠乙状结肠壁增厚5例;直肠周围脂肪水肿模糊8例;子宫骶骨韧带增厚10例;输尿管扩张3例等。结论输卵管脓肿、输卵管卵巢脓肿具有特征性影像表现,CT及MR为输卵管与卵巢脓肿较好的检查方法。

Diagnosis of fallopian tube and ovarian abscess with SCT and MRI

Objective To evaluate the value of spiral CT and MRI in the diagnosis of fallopian tube abscess(FTA) and tuboovarian abscess(TOA). Methods The imaging data of CT and MRI of 20 patients with pathologically proved FTA and TOA were retrospectively analyzed. 16 patients were examined by CT and 4 patients were exam- ined by MR. Results Six FTAs presented with tubular cystic adnexal masses(n=4) and fallopian tube wided(n=2), with thicked, enhancing wall, thin internal septa and pyosal- pinx on computed tomography. Fourteen TOAs presented with ill-defined margin, thick- ened wall, multiple internal septa, cystic-solid adnexal masses. Before contrast enhance- ment scaned, 10 cases appeared intermediate and low mixture density on computed tomography, 4 cases appeared iso-to hypo-intense on MR T1WI and heterogeneous hyper-intense on T2WI. The solid part, thickened wall and internal septa all marked homogeneously enhanced on CT and MR contrast scan. Additional signs including the striped and gridding trace around the absces(sn=5), conglutinated to the body of uterus (n=12), thickening of the mesosalpinx (n=8), rectosigmoid bowel thickening(n=5), in- creased attenuation of edematous perirectal fat(n=8), thickening of the uterosacral ligaments(n=10), hydroureter(n=3), and so on. Conclusion The findings of FTAs and TOAs are characteristiced on CT and MR, which are useful tools on the examination of them.