超声联合MRI诊断中晚期妊娠合并附件扭转的价值  

Ultrasound Combined with MRI in the Diagnosis of Middle and Late Pregnancy Complicated with Appendix Torsion

作　　者：郭志 方必东[2] 赵雅萍[2] 陈棋[2] 毕俊英 秦涛 吴爱琴[2] 许崇永[2] GUO Zhi;FANG Bi-dong;ZHAO Ya-ping;CHEN Qi;BI Jun-ying;QIN Tao;WU Ai-qin;XU Chong-yong(Department of Radiology, the Third General Hospital of Hubei Province, Wuhan, Hubei 430033;Department of Radiology and Department of Ultrasonography, the Second Hospital of Wenzhou Medical College, Wenzhou, Zhejiang 325027, China)

机构地区：[1]湖北省第三人民医院放射科,湖北武汉430033 [2]温州医科大学附属第二医院影像科超声科,浙江温州325027

出　　处：《湖北医药学院学报》2019年第4期344-347,共4页Journal of Hubei University of Medicine

摘　　要：目的:探讨中晚期妊娠合并附件扭转的超声及MRI诊断价值。方法:回顾性分析我院2011年2月~2017年6月经手术及病理证实的中晚期妊娠合并附件扭转患者12例,结合临床资料分析其超声及MRI表现特征。结果:12例中,超声探及母体附件区囊性或囊实性包块11例,卵巢增大伴回声不均1例,合并盆腔积液4例。CDFI示包块内及周边有血供4例,无血供8例。5例行MRI检查,均表现为附件区异常信号团块,卵巢蒂扭转呈典型结节征(或漩涡征)2例,三角征2例,悬挂征1例;肿瘤囊壁或分隔不规则增厚3例;囊壁出血2例。术中示2例肿瘤蒂扭转180°,10例肿瘤蒂扭转360°~900°;病理7例肿瘤表面淤血,8例伴出血及坏死,4例合并盆腔积血。结论:中晚期妊娠合并附件扭转的超声及MRI表现具有一定特征性,结合患者临床症状及体征能够为诊断及临床治疗提供有价值的信息。Objective To investigate the diagnostic value of ultrasound and magnetic resonance imaging(MRI)in middle and late pregnancy complicated with appendix torsion. Methods A retrospective analysis was made on 12 cases of mid-late pregnancy with torsion of appendix confirmed by surgery and pathology from February 2011 to June 2017 in our hospital. The ultrasound and MRI features were analyzed in combination with clinical data. Results Of 12 cases, ultrasound detected maternal adnexal cystic or cystic-solid masses in 11 cases and enlarged maternal ovary associated with heterogeneous echo in 1 case,pelvic hemorrhage in 4 cases. CDFI showed inside or peripheral blood flow of the tumor in 4 cases, no blood flow in 8 cases. 5 cases of MRI examination demonstrated abnormal signal mass in the annex area. The ovarian pedicle torsion presented typical "nodule sign" or "whirlpool sign"(n=2),"triangle sign"(n=2),"suspension sign"(n=1). There were irregular thick cystic wall and septum of the tumor in 3 case, hemorrhage of cystic wall in 2 cases. Operation displayed 180 °torsion in 2 cases and 360 °~ 900 °torsion in 10 cases. Pathology confirmed surface congestion of the tumor in 7 cases, hemorrhage and necrosis in 8 cases, pelvic hemorrhage in 4 cases. Conclusion The ultrasound and MRI findings of mid-late pregnancy with accessory torsion have certain characteristics. Combining with clinical symptoms and signs of the patients, it can provide valuable information for clinical diagnosis and treatment.

关 键 词：围产期 附件扭转 磁共振成像 超声 

分 类 号：R445[医药卫生—影像医学与核医学] R714.25[医药卫生—诊断学]