卵巢黄体囊肿破裂CT、MRI误诊分析  

CT and MRI misdiagnosis analysis of ruptured corpus luteum cyst of ovary

作　　者：张德清[1] 杜小旦 田雪 胡云方 孟志华[1] 陈振松[1] ZHANG Deqing;DU Xiaodan;TIAN Xue;HU Yunfang;MENG Zhihua;CHEN Zhensong(Imaging Center,Yuebei People's Hos pital,Shaoguan,Gruangdong Prorince 512026,China;Department of Radiology,Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine,Zhuhai,Gruangdomg Prorince 519000,China;Imaging Center,the First Affiliated Hospital of Xinjiang Medical Universily,Urumqi 830054,China;Computer Center,Yuebei People's Hospital,Shaoguan,Gruangdong Province 512026,China)

机构地区：[1]粤北人民医院影像中心,广东韶关512026 [2]珠海市中西医结合医院影像科,广东珠海519000 [3]新疆医科大学第一附属医院影像中心,新疆乌鲁木齐830054 [4]粤北人民医院信息中心,广东韶关512026

出　　处：《实用放射学杂志》2022年第4期600-603,共4页Journal of Practical Radiology

摘　　要：目的探讨CT、MRI误诊卵巢黄体囊肿(OCLC)破裂的原因.方法回顾性分析31例CT、MRI误诊的OCLC破裂患者手术病理及影像资料.22例急诊手术患者中,19例术前行腹盆腔CT平扫,3例行CT增强扫描.9例择期手术患者中,3例术前行CT增强、5例行MRI增强、1例行CT和MRI增强扫描.2名高年资影像医生回顾阅片,对照病理分析影像征象,评价误诊原因.结果误诊为异位妊娠破裂15例、附件扭转破裂3例、卵巢囊肿/肿瘤破裂8例、阑尾及盆腔炎各2例、消化道穿孔1例.回顾阅片14例诊断OCLC破裂,平扫影像诊断6例、增强8例.对照病理31例盆腔均发现囊肿或类似影像;9例CT和6例MRI图像能分辨盆腔积血;6例CT和6例MRI图像可见囊肿内出血;2例增强CT和3例MRI图像可见囊肿壁破口.结论OCLC破裂的CT、MRI表现复杂多样、无特异性是误诊的主要原因.结合病史,完善检查,提高妇科急腹症影像认识,能显著减少误诊.Objective To investigate the misdiagnosis reasons for rupture of ovarian corpus luteum cyst(OCLC)by CT and MRI.Methods The surgical pathology and imaging data of 31 patients with OCLC rupture misdiagnosed by CT or MRI were analyzed retrospectively.Among 22 patients underwent emergency surgery,19 patients underwent abdominal and pelvic CT plain scan and 3 patients underwent enhanced CT scan.Among 9 patients underwent elective surgery,3 patients underwent enhanced CT scan,5 patients underwent MRI enhancement,and 1 underwent both CT and MRI enhancement.Two senior radiologists reviewed all of the images,and analyzed the imaging signs and evaluated the reasons of misdiagnosis.Results 15 cases were misdiagnosed as ectopic pregnancy rupture,3 cases were misdiagnosed as accessory torsion rupture,8 cases were misdiagnosed as ovarian cyst/tumor rupture,2 cases were misdiagnosed as appendicitis and pelvic inflammatory,and 1 case was misdiagnosed as digestive tract perforation.Among 14 cases diagnosed as OCLC rupture retrospectively,6 cases were diagnosed by non-enhancement imaging,and 8 cases were diagnosed by enhanced imaging.Compared with pathology,cysts or similar images in the pelvic cavity were found in all of the 31 cases;pelvic hematocele were found in 9 cases by CT and 6 cases by MRI;intra-cystic hemorrhage were detected in 6 cases by CT and 6 cases by MRI;cyst wall rupture were detected in 2 cases by enhanced CT and 3 cases by MRI.Conclusion The CT and MRI images of OCLC rupture are complex and non-specific,which is the main reason for misdiagnosis.Combining with the history,complete examination and improving the image understanding of gynecologic acute abdomen can significantly reduce the misdiagnosis.

关 键 词：卵巢黄体囊肿 破裂 计算机体层成像 磁共振成像 

分 类 号：R711.75[医药卫生—妇产科学] R814.42[医药卫生—临床医学] R445.2