卵巢病变蒂扭转的MRI特征分析  

MRI features of pedicle torsion of ovarian lesion

作　　者：张成周[1,2] 王萍 翟长彬[1] 殷志杰[1] 钟晓飞 王静[1] ZHANG Chengzhou;WANG Ping;ZHAI Changbin;YIN Zhijie;ZHONG Xiaofei;WANG Jing(Department of Radiology,the Affiliated Hospital of Binzhou Medical University ,Binzhou 256603,China;Department ofRadiology,Yantai Yuhuangding Hospital,Yantai 264000,China)

机构地区：[1]滨州医学院附属医院放射科,山东滨州256603 [2]烟台毓璜顶医院放射科,山东烟台264000

出　　处：《实用放射学杂志》2019年第1期73-76,共4页Journal of Practical Radiology

摘　　要：目的 探讨卵巢病变蒂扭转的MRI特征。 方法 回顾性分析经手术病理证实的10例卵巢病变蒂扭转患者的MRI资料,所有患者均行常规MR平扫、DWI扫描,6例患者同时行MR增强扫描。 结果 (1)10例中囊性病变9例,实性病变1例。(2)MRI上显示蒂扭转9例,表现为肿物旁的实性信号影,4例可见“漩涡状”改变。7例伴出血梗死者ADC图可见低信号,2例不伴出血梗死者ADC图未见低信号。(3)9例囊性病变均可见囊壁和/或分隔增厚。7例伴出血梗死的患者中,5例于T2WI、DWI和ADC图上囊壁可见低信号,3例于T1WI上囊壁或实性部分可见高信号。3例不伴出血梗死者囊壁T2WI未见低信号、T1WI未见高信号。(4)囊内出血7例,其中2例可见液-液平面。(5)增强后囊壁强化3例,囊壁不强化而囊壁周围组织环形强化3例。 结论 蒂扭转是MR诊断卵巢扭转的特异性征象,蒂扭转ADC图出现低信号、囊壁出现T1WI高信号和/或T2WI低信号、囊壁不强化时提示合并出血梗死可能。Objective To clarify the MRI features of pedicle torsion of ovarian lesion.Methods The MRI data of 10 cases with surgical confirmation of pedicle torsion of ovarian lesions were analyzed retrospectively.All patients underwent routine MR scan and DWI scan,six cases simultaneously underwent enhanced MR examination.Results (1)Among the ten cases,there were nine cases of cystic lesions,and one case of solid lesions.(2)The pedicle torsions were identified in nine cases on MRI,which showed solid signal intensity beside the mass,and four cases showed whirl sign.On ADC images,seven cases with hemorrhagic infarction showed hypointensity, and no hypointensity signal was found in two cases without hemorrhagic infarction.(3)Wall thickening was observed in all nine cystic cases.Five out of seven cases with hemorrhagic infarction showed hypointensity signal on T2WI,DWI and ADC images,three cases showed hyperintensity signal on T1WI.Three cases without hemorrhagic infarction showed no hypointensity signal on T2WI or hyperintensity signal on T1WI.(4)Seven cases showed intracapsular hemorrhage,and two of which showed liquid level.(5)Three cases showed wall enhancement,and the other three cases showed no wall enhancement,while circular enhancement of the tissue around the wall was observed.Conclusion The detection of pedicle torsion is considered to be the most specific MR finding for ovarian torsion. While the pedicle torsion showed hypointensity on ADC images,the wall showed T1WI hyperintensity/T2WI hypointensity signal,or lack of wail enhancement are suggested to be ovarian torsion with hemorrhagic infarction.

关 键 词：卵巢 蒂扭转 磁共振成像 

分 类 号：R711.75[医药卫生—妇产科学] R445.2[医药卫生—临床医学]