儿童卵巢扭转影像学征象分析  

Analysis of imaging signs of ovarian torsion in children

作　　者：马慧[1] 戴李华 王映飞[1] 林剑军[1] 唐秋云 许大幸 MA Hui;DAI Lihua;WANG Yingfei;LIN Jianjun;TANG Qiuyun;XU Daxing(Department of Radiology,the Maternal and Child Health Hospitalof Guangxi Zhuang Autonomous Region,Nanning 530003,China)

机构地区：[1]广西壮族自治区妇幼保健院放射科,广西南宁530003

出　　处：《实用放射学杂志》2025年第2期285-288,共4页Journal of Practical Radiology

摘　　要：目的总结分析儿童卵巢扭转的CT或MRI影像学征象。方法回顾性分析经手术证实24例儿童卵巢扭转的CT或MRI资料,通过分析卵巢位置、大小及与周围附件、子宫关系等影像征象进行总结。结果本组病例中行CT检查8例,MRI检查16例。患儿中新生儿12例,学龄期及青春期儿童各6例,以新生儿及10~12岁左右儿童多见。24例患儿中,原发性卵巢扭转3例(12.5%),均为青春期儿童;继发性卵巢扭转21例(87.5%),新生儿期均为继发性卵巢扭转。继发性卵巢扭转中卵巢畸胎瘤合并扭转7例(33.3%),单纯卵巢囊肿12例(57.1%),卵巢浆液性囊腺瘤1例(4.7%),卵巢黏液性囊腺瘤1例(4.7%)。扭转发生于左侧卵巢9例(37.5%),右侧卵巢15例(62.5%),以右侧卵巢扭转多见。影像学征象:扭转同侧卵巢均有不同程度增大,卵巢肿块最大径≥5 cm 14例(58.3%),其中新生儿期以3~5 cm多见;扭转同侧出现蒂征/旋涡征11例(45.8%);肿块合并出血9例(37.5%);肿块向中线移位/子宫向同侧移位4例(16.7%),卵巢内卵泡外移出现果盘征3例(12.5%)。结论儿童卵巢扭转以继发性多见,其影像学表现具有一定特征,尤其是新生儿卵巢囊肿出现出血信号要警惕卵巢扭转的风险;CT及MRI检查能为儿童卵巢扭转临床诊断提供有力参考。Objective To summarize and analyze the CT or MRI imaging signs of ovarian torsion in children.Methods The CT or MRI data of 24 children surgically confirmed ovarian torsion were analyzed retrospectively,focusing on imaging signs such as ovarian position,size,the relationship with surrounding appendages and uterus.Results In this group of cases,8 cases underwent CT examination and 16 cases underwent MRI examination.Among the age of children,12 cases were in newborns,and 6 cases were in school-age and adolescent children respectively.It was more common in newborns and children aged 10-12 years old.Among the 24 patients,3 cases(12.5%)had primary ovarian torsion,all of which were adolescent children;21 cases(87.5%)had secondary ovarian torsion,with all torsions in the neonatal period were secondary ovarian torsion.Among secondary ovarian torsion,there were 7 cases(33.3%)of ovarian teratoma with torsion,12 cases(57.1%)of simple ovarian cysts,1 case(4.7%)of ovarian serous cystadenoma,and 1 case(4.7%)of ovarian mucinous cyst.Torsion occurred in 9 cases(37.5%)of the left ovary and 15 cases(62.5%)of the right ovary,with right ovarian torsion being more common.Imaging signs included varying degrees of enlargement of the ovaries on the ipsilateral side of the torsion,with 14 cases(58.3%)of ovarian masses had a maximum diameter≥5 cm,and 3-5 cm being more common in the neonatal period.There were 11 cases(45.8%)with the pedicle sign/vortex sign on the ipsilateral side of the torsion,9 cases(37.5%)with mass and hemorrhage,4 cases(16.7%)with mass displacement to the midline or uterine displacement to the ipsilateral side,and 3 cases(12.5%)of the ovarian follicle outward migration showed fruit bowl sign.Conclusion Secondary ovarian torsion is relatively common in children,with distinctive imaging manifestations.Especially when neonatal ovarian cysts show hemorrhagic signals should be alert to the risk of ovarian torsion.CT and MRI examinations can provide a powerful reference for the clinical diagnosis of ovarian torsion in chi

关 键 词：卵巢扭转 儿童 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