卵巢黄体血肿与畸胎瘤超声声像图的对比研究
摘要
目的:探讨卵巢黄体血肿与畸胎瘤的超声声像图特征,提高超声对二者的鉴别诊断能力。方法:回顾性分析109例卵巢黄体血肿和畸胎瘤的声像图表现,其中58例黄体血肿连续随访观察3～6个月逐渐缩小、消失或手术证实,51例畸胎瘤经手术病理证实,比较二者二维声像图及彩色多普勒血流方面特征。结果:58例黄体血肿中囊内含高回声区48例,呈网格状回声33例,周边环状血流信号16例,RI平均值0.58,误诊7例;51例畸胎瘤中超声诊断34例,面团征4例,短线征10例,脂液分层征2例,囊内高回声区40例,其中团状高回声后方伴声影21例,不能明确诊断18例,漏诊3例:卵巢黄体血肿和畸胎瘤囊内含高回声区二者之间的比较,无统计学意义(P＞0.05):黄体血肿典型声像图表现:囊内网格状回声及周边环状血流信号,与畸胎瘤鉴别有统计学意义(P＜0.05);畸胎瘤典型声像图表现:囊内团状高回声后方伴声影,与黄体血肿鉴别有统计学意义(P＜0.05)。结论:超声对卵巢黄体血肿与畸胎瘤有很好的诊断价值。
Objective: To explore the ultrasonic sonography characters of ovarian luteum hematon and teratom, improve the ultrasonic importance the differenciating and diagnosing ovarian luteum hematon and teratom. Methods: A retrospective study on 109 cases sonography characters of ovarian luteum hematon and teratom, 58 cases luteum hematon patients confirmed by observing 3～6 months or operation, 51 cases ovarian teratom patients confirmed by operation and pathology, compare sonography characters between two-dimensional and color Doppler energy (CDE).Results: hyperecho area in cysts 48 cases among 58 cases luteum hematon, cobwel septations echo 33 cases, 16 cases with circle blood flow in pericyst were reviewed in the study, (RI averaged on 0.58),misdiagnosis were 7 cases;Ultrasound pointed out 34 cases among 51 cases ovarian teratom, dough sign 4 cases, short-line 10 cases, fat-fluid level 2 cases, hyperecho area in cysts 40 cases, hyperecho group with posterior shadow 21 cases,There were still 18 cases ultrasound couldn't demonstrate, missed diagnosis were 3 cases; hyperecho area in ovarian luteum hematon and teratom has no statistical significance (P>0.05) ; Ovarian luteum hematon characteristic features were as follows: (1) cobwel septations echo was seen in the cyst (2) circle blood flow in pericyst, to compare with teratom, They are obviously significant (P<0.05) ;Teratom characteristic feature was hyperecho group with posterior shadow, to compare with luteum hematon, this is obviously significant (?< 0.05) .Conclusion: The ultrasound is the most cost-effective method in diagnosing ovarian luteum hematon and teratom.
Objective: To explore the ultrasonic sonography characters of ovarian luteum hematon and teratom, improve the ultrasonic importance the differenciating and diagnosing ovarian luteum hematon and teratom. Methods: A retrospective study on 109 cases sonography characters of ovarian luteum hematon and teratom, 58 cases luteum hematon patients confirmed by observing 3～6 months or operation, 51 cases ovarian teratom patients confirmed by operation and pathology, compare sonography characters between two-dimensional and color Doppler energy (CDE).Results: hyperecho area in cysts 48 cases among 58 cases luteum hematon, cobwel septations echo 33 cases, 16 cases with circle blood flow in pericyst were reviewed in the study, (RI averaged on 0.58),misdiagnosis were 7 cases;Ultrasound pointed out 34 cases among 51 cases ovarian teratom, dough sign 4 cases, short-line 10 cases, fat-fluid level 2 cases, hyperecho area in cysts 40 cases, hyperecho group with posterior shadow 21 cases,There were still 18 cases ultrasound couldn't demonstrate, missed diagnosis were 3 cases; hyperecho area in ovarian luteum hematon and teratom has no statistical significance (P>0.05) ; Ovarian luteum hematon characteristic features were as follows: (1) cobwel septations echo was seen in the cyst (2) circle blood flow in pericyst, to compare with teratom, They are obviously significant (P<0.05) ;Teratom characteristic feature was hyperecho group with posterior shadow, to compare with luteum hematon, this is obviously significant (?< 0.05) .Conclusion: The ultrasound is the most cost-effective method in diagnosing ovarian luteum hematon and teratom.
引文
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[3]万青,余虹,高培华.卵巢血肿的超声诊断与临床价值.中国超声诊断杂志,2004,5(5):366-368
[4]张晶,董宝玮,梁萍,等.肝实性占位超声回声特征的病理基础.中华超声影像学杂志,2000,9(4)206-209
[5]Ishihara k,Nemoto Y.sonographic appearance of hemorrhagic ovarian cyst with acuteabdomen by transvaginal scan Nippon Ika DaigakuZasshi,1997,64:411-4156
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[8]T.Tohya.Conservation management of the acute abodomen secondary to hemorrhagicdisease of the ovary.Intenational Journal Gynecology and Obstetrics,2003,80:165-166
[9]吴锦春,段晓玲,王桂珍.超声显像对卵巢血肿的诊断.中国超声诊断杂志,2002,3(2):120-121
[10]乐杰,妇产科学[M]北京:人民出版社,2000,336
[11]Morillo Conejo M,Martin Canadas F,Munoz Carmona V,Gonzalez-Sicilia Munoz E,et al.Ovarian mature teratoma.Clinicopathological study of 112 cases and review ofthe literature Ginecol Obstet Mex,2003,71:447-454
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[13]袁梅,赵诚,孙咏梅,等.经阴道超声显像对卵巢囊性畸胎瘤的诊断.中国医学影像技术,2001:679-680
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[15]于丽,马茹,肖丽萍.经腹和阴道联合二维超声诊断附件良性包块的评价.中国实用妇科和产科杂志,2004,20(11):687-688
铩颷16]Canda AE,Astarcioglu H,Obuz F,Cystic ovarian teratoma with intracystic floatingglobules.Abdominal Imaging,2005,30(3):369-71
[17]向红,吕永泉,宋建兵.经阴道彩色多普勒能量显像在卵巢小肿块诊断的应用.中国医学影像学技术,2003,19(10)1323-1324
[18]雷进,王峰,段扬,等.出血性卵巢囊肿的超声诊断[J].中华超声影像学杂志,2003,4(12):247
[19]李新新,张玉清,陈苏兰,等.未破裂卵巢血肿的声像图表现.中国医学影像学技术,2001,17(3):259
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[21]孔秋英,谢红宁主编。妇产科影像诊断与介入治疗学.北京:人民卫生出版社,2001.304-305
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[23]佘劲松,曾繁慧.35例卵巢囊性畸胎瘤的B超诊断分析.临床超声学杂志,2003,5(5):312
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