附件脓肿的CT诊断

目的 探讨附件脓肿的CT特征及其诊断价值.方法 回顾性分析26例经手术证实的附件脓肿,分析其CT影像表现.结果 26例附件脓肿中,单侧6例,双侧20例,共46个病灶,其中输卵管脓肿33个病灶,输卵管卵巢脓肿13个病灶.输卵管脓肿的CT征象为输卵管壁增厚,呈管状、囊状或多房囊状扩张,输卵管积脓.输卵管卵巢脓肿多表现为多房囊实性肿块,卵巢脓肿位于中心,外围由输卵管脓肿包绕,脓肿壁呈环形10例,团片状3例,增强扫描脓肿壁呈分层强化.盆腔结缔组织炎21例,表现为盆腔脂肪模糊、密度增高,宫骶韧带增厚,盆腔腹膜炎.输卵管卵巢脓肿与周围结构粘连,其中5例引起肠梗阻,3例引起输尿管积水.子宫内膜炎19例,腹水18例.结论 附件脓肿的CT表现具特征性,掌握其影像特征及其与周围结构的关系,对疾病的及时诊断与治疗非常重要.

The diagnostic value of CT in adnexal abscess

Objective To evaluate the value of CT in diagnosis of adnexal abscess retrospectively.Methods The characteristic CT findings in 26 patients with adnexal abscess proved by histopathology were reviewed retrospectively.Results Of 26 patients,the adnexal abscess was presented in unilateral lesions(n=6) and bilateral lesions(n=20).There were total 46 lesions,which were pyosalpingitis (n=33) and tubo-ovarian abscess (n=13),respectively.CT findings of pyosalpingitis included dilated, thick-walled, enhancing fallopian tubes containing complex fluid.CT findings in tubo-ovarian abscess were thick-walled and multiloculated cystic masses,which had thick mural enhancement with multilayered appearance (n=10).Reactive inflammation of adjacent structures(n=21) manifested as haziness and stranding of the pelvic fat,thickening of the uterosacral ligaments, and pelvic peritonitis.Small or large bowel ileus (n=5) and hydroureter (n=3) resulted from adjacent inflammation of tubo-ovarian abscess.Endometritis was seen in 19 patients and ascites in 18 patients.Conclusion Familiarity with the CT appearances is important for timely diagnosis and treatment of adnexal abscess and its complications.