输卵管积液的 MRI 诊断及其临床应用价值  

MRI diagnosis of the hydrosalpinx and the clinical application value

作　　者：东强 史婧[1] 储成凤[1] 李保红[1] 车子刚[1] 司明远 彭丽红 

机构地区：[1] 东南大学医学院附属南京同仁医院 影像科 [2] 病理科,江苏 南京211102

出　　处：《实用放射学杂志》2015年第7期1144-1147,1170,共5页Journal of Practical Radiology

摘　　要：目的：分析输卵管积液的 MRI 影像学特征，探讨 MRI 诊断该病的临床应用价值。方法回顾性分析40例经手术、病理证实的53条输卵管积液的 MRI、B 超表现，并与腹腔镜、病理结果对照分析。结果53条输卵管积液中，双侧性13例，单侧性27例；输卵管扩张呈腊肠状32条、曲颈瓶状16条、囊袋状5条；管腔内见不完全分隔影19条。临床及病理诊断急性输卵管炎患者9例共15条输卵管积脓、扩张；慢性输卵管炎患者31例共38条输卵管积液、扩张，其中14条伴有积血。MRI、B 超诊断输卵管积液的敏感性分别为94.3%（50/53）、88.7%（47/53），无统计学差异（P 〉0.05）；特异性分别为90.6%（48/53）、77.6%（41/53），有明显统计学差异（P 〈0.05）。结论 MRI 对输卵管积液定位、定性的诊断优于 B 超，可根据管内积液的信号特点分辨囊液的性质，对急性、慢性输卵管炎所致的输卵管积液作出明确诊断。Objective To analyze the MRI features of hydrosalpinx and to investigate its clinical value.Methods MRI and ultrasound manifestations in 40 patients with hydrosalpinx in 53 fallopian tubes confirmed by operative and pathological findings were analyzed retrospectively,and these findings were also compared with the results of aparoscopy and pathology.Results Among 53 fallopian tubes with hydrosalpinx,bilateral tubes in 13 patients and 27 unilateral tubes in other patients were found.The tubes were botuliform in 32, retort-shaped in 1 6,pouch-shaped in 5.Incomplete separation of the lumen were found in 1 9.In 9 patients with acute salpingitis,1 5 tubes were found with empyema and expansion.In other 31 patients with chronic salpingitis,38 tubes were with hydrops and expansion,14 of whom were with hematocele.The sensibilities of MRI and ultrasound diagnosis for hydrosalpinx were 94.3%（50/53）and 88.7%（47/53）with no statistical differences（P 〉0.05）,however the specificitis were 90.6%（48/53）and 77.6%（41/53）with obvious statistical differences（P 〈0.05）.Conclusion The locating and qualitative diagnosis of MRI for hydrosalpinx is superior to ultrasound.MRI can discriminate the quality of cyst fluid and thus can definitely diagnose the hydrosalpinx caused by acute or chronic salpingitis.

关 键 词：输卵管积液 输卵管炎 磁共振成像 

分 类 号：R711.76[医药卫生—妇产科学] R445.2[医药卫生—临床医学]