CT诊断附件扭转及预测卵巢坏死的价值  

CT value in adnexal torsion diagnosis and ovarian necrosis prediction

作　　者：邹俊婷 段娜[1] 朱丽 陈静[1] 陈晨[1] 王中秋[1] ZOU Junting;DUAN Na;ZHU Li;CHEN Jing;CHEN Chen;WANG Zhongqiu(Department of Radiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院放射科,江苏南京210029

出　　处：《中国中西医结合影像学杂志》2024年第6期700-704,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：江苏省中医院高峰学术人才项目(第一层次)(y2021rc03)。

摘　　要：目的:探讨CT对附件扭转的诊断价值及对卵巢坏死的预测价值。方法:回顾性分析40例经手术病理证实的附件扭转患者的临床、病理及影像资料,根据附件扭转后卵巢有无坏死,分为坏死组24例和未坏死组16例。通过多因素logistic回归分析评估2组CT征象的差异。结果:40例病灶最大径平均(9.98±3.02)cm;38例囊性病灶中囊壁增厚26例;蒂扭转31例,呈漩涡征14例、绳索征22例、双瘤征14例和新月征13例,扭转蒂出血26例,扭转蒂无明显强化10例;子宫患侧偏移23例,盆腔积液29例,周围脂肪间隙模糊19例。2组囊壁增厚、扭转蒂出血、扭转蒂无明显强化的发生率差异均有统计学意义(均P<0.05);余CT征象组间差异均无统计学意义(均P>0.05)。多因素logistic回归分析表明,扭转蒂出血[OR=25.152(95%CI1.445~437.895),P=0.027]与附件扭转后卵巢坏死有关,其预测卵巢坏死的AUC为0.833。结论:CT发现扭转蒂可明确附件扭转的诊断,扭转蒂出血可预测附件扭转后卵巢坏死。Objective:To explore the value of CT in the diagnosis of adnexal torsion and the prediction of ovarian necrosis.Methods:40 cases of adnexal torsion confirmed by surgery and pathology were analyzed retrospectively,with complete clinical,pathological and imaging data.40 patients were divided into the necrotic group(24 cases)and the non-necrotic group(16 cases).The differences of CT features between the two groups were evaluated by multivariate logistic regression analysis.Results:The average maximum diameter of lesions was(9.98±3.02)cm.26 lesions had wall thickening in 38 cystic lesions.31 cases had twisted pedicles,presenting as whirlpool sign(14 cases),rope sign(22 cases),double tumor sign(14 cases)and crescent sign(13 cases).26 cases had hemorrhage in twisted pedicle.10 cases had poor enhancement in twisted pedicle.Uterine deviation to the affected side was seen in 23 patients,pelvic effusion was seen in 29 patients,and peripheral adipose space was blurred in 29 patients.The incidences of wall thickening,hemorrhage and poor enhancement in twisted pedicle had statistical differences between the two groups(all P<0.05),whereas no significant difference was observed in other CT features(all P>0.05).Multivariate logistic analysis showed that hemorrhage in twisted pedicle[OR=25.152(95%CI 1.445~437.895),P=0.027]was associated with ovarian necrosis after adnexal torsion,and AUC was 0.833.Conclusions:The presence of twitsed pedicle on CT scan can confirm the diagnosis of adnexal torsion.Hemorrhage in twisted pedicle can predict ovarian necrosis after adnexal torsion.

关 键 词：卵巢 扭转 坏死 体层摄影术 X线计算机 

分 类 号：R713[医药卫生—妇产科学] R816.91[医药卫生—临床医学]