卵巢病变蒂扭转的MRI表现特征及与病理对照分析

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摘要目的探讨卵巢病变蒂扭转的MRI表现，旨在提高对其MRI征象的认识及诊断水平。方法回顾性分析2012年3月~2017年3月东莞市妇幼保健院经手术病理证实的12例卵巢病变蒂扭转患者的MRI资料，观察扭转蒂、扭转后病变及其周围结构的MRI表现。对蒂扭转部位和扭转程度的MRI表现进行探讨。结果 12例均为卵巢良性病变。扭转蒂为实性结构，6例条索样、4例环样、2例结节样，10例内见流空血管。患侧病变为囊实性或囊性结构，呈偏心性增厚，病变内及边缘见出血灶。10例扭转蒂由卵巢韧带及输卵管组成，6例上下方向扭转，4例内外方向扭转，呈条索样、环样；2例扭转蒂是卵巢与病灶之间的蒂，呈结节样。依据含流空血管的条索样、环样结构联合病变偏心性增厚诊断蒂扭转符合率为92%。扭转半圈囊壁轻度增厚，扭转2~5圈，囊壁偏心性增厚，扭转5圈囊壁最厚。2例扭转5圈合并供血动脉增粗。结论卵巢病变扭转蒂及扭转后肿块有特征性的MRI表现，能初步认识扭转发生的部位及辨别病变蒂扭转严重程度（扭转圈数）。

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	王亚1 王强1 郑晓林2 龚苗苗1 杨益刚1 王忠1

关键词 ：核磁共振成像, 卵巢, 卵巢病变, 扭转

Abstract：Objective To evaluate MRI manifestations of ovarian diseases with pedicle torsion and promote the knowledge and diagnostic level. Methods The MRI manifestations of 12 patients with pedicle torsion of ovarian diseases which were confirmed by surgery and pathology from March 2012 to March 2017 in Dongguan Maternal and Child Health Care Hospital were retrospectively analyzed. The twisted pedicles, signal characteristic of the diseases and vascular changes near by the torsion were studied. The MRI manifestations of torsional positio and torsional degrees of pedicle were investigated. Results Twelve patients were benign ovarian lesions. The torsion pedicle which was solid mass-like structures showed irregular long soft tissue (n = 6), with round and circle shape (n = 4), and nodular shape (n = 2), 10 with vascular signal. The lesions were cystic or cystic-solid, which proved eccentric wall thickening, and with hemorrhage. The pedicle torsion was composed of the ovarian ligament and the oviduct (n = 10); the lesion turned in up and down direction (n = 6); the lesion turned in inside and outside direction (n = 4). The pedicle torsion was composed of the ovary between the lesion (n = 2). MRI show cord-like structure, ring like structure with vascular signal diagnosis torsion with diagnostic coincidence was 92% in the combined of eccentric thickening. The wall of the torsional which was twisted half circle was slightly thickened, and 2-5 circles was eccentric wall thickening, 5 circles was most thicken. The artery was enlarged which was twisted 5 circles. Conclusion Ovarian diseases pedicle torsion have some MRI characteristic manifestations, understanding the location of the torsion, distinguishing the severity of torsion (different twisted turns).

Key words： Magnetic resonance imaging Ovary Ovarian diseases Torsion

通讯作者: 王忠（1968-），男，主任医师；研究方向：儿科急腹征影像学诊断。

作者简介: 王亚（1983-），女，硕士；研究方向：妇产科MRI功能成像。

引用本文:

王亚1 王强1 郑晓林2 龚苗苗1 杨益刚1 王忠1. 卵巢病变蒂扭转的MRI表现特征及与病理对照分析[J]. 中国医药导报, 2018, 15(18): 92-95.
WANG Ya1 WANG Qiang1 ZHENG Xiaoling2 GONG Miaomiao1 YANG Yigang1 WANG Zhong1. Comparative study of MRI and pathological manifestations of ovarian diseases with pedicle torsion. 中国医药导报, 2018, 15(18): 92-95.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I18/92

[1] 黄昌举.彩色多普勒超声对于妇产科急腹症的诊断价值[J].齐齐哈尔医学院学报，2014，35（10）：1465-1466.
[2] 饶敏，潘自来，段娜，等.卵巢蒂扭转的多层螺旋CT诊断[J].中国医学计算机成像，2016，22（4）：327-3307.
[3] Lourcenco AP，Swenson D，Tubbs RJ，et al. Ovarian and tubal torsion：imaging findings on US，CT，and MRI [J]. Emergency Radiology，2014，21（2）：179-187.
[4] Pooai N，Poonai C，Lim R，et al. Pediatric ovarian torsion：Case series and review of the literature [J]. Can J Surg，2013， 56（2）：103-108.
[5] Saski KJ，Miller CE. Adnexal torsion：review of the literature [J]. J Minim Invasive Gynecol，2014，21（2）：196-202.
[6] Lee JH，Park SB，Shin SH，et al. Value of intra-adnexal and extra-adnexal computed tomographic imaging features diagnosing torsion of adnexal tumor [J]. J Comput Assist Tomogr，2009，33（6）：872-876.
[7] 蒋开航，李永容，陈家飞，等.卵巢囊肿蒂扭转的CT和MRI诊断价值[J].局部手术学，2013，22（3）：275-277.
[8] 方如旗，曹代荣，翁淑萍，等.卵巢肿瘤蒂扭转的MRI影像表现（附８例报告）[J].临床放射学，2012，31（5）：684-687.
[9] 丁永刚，蔡金华，秦勇，等.儿童卵巢扭转的MSCT表现[J].中国介入影像与治疗学，2015，12（5）：349-352.
[10] 陈卫鹏，林鹏典，林海韬，等.学龄期儿童卵巢蒂扭转的MRI诊断初探[J].影像诊断与介入放射学，2015，24（5）：421-424.
[11] Duigenan S，Oliva E，Lee SI. Ovarian torsion：diagnostic features on CT and MRI with pathologic correlation [J]. AJR Am J Roentgenol，2012，198（2）：122-131.
[12] Van Kerkhove F，Cannie M，Op de Beeck K，et al. Ovarian torsioin a premenarcheal girl：MRI findings [J]. Abdom Imaging，2007，32（3）：424-427.
[13] 丁永刚，单凯，蔡金华，等.MSCTA辅助儿童卵巢肿瘤蒂扭转定位诊断及精准手术[J].局部手术学，2016，25（8）：577-580.
[14] Sepulveda W，Wong AE，Herrera L，et al. Endoscopic laser coagulation of feeding vessels in large placenta chorioangiomas report of three cases and review of invasive treatment options [J]. Prenat Diagn，2009，29（3）：201-206.
[15] Meltem CO，Cigdem UD，Kaan M，Surgical approach to ovarian torsion in children [J]. J Pediatr Adolesc Gynecol，2015，28（5）：343-347.
[16] 王维刚.MRI在评估宫颈癌浸润范围的临床价值[J].中国医药导报，2009，11（1）：5-9.
[17] 肖慧君，康正武，王俊杰，等.MRI在卵巢纤维卵泡膜细胞瘤诊断中应用的价值[J].中国卫生标准管理，2016，8（19）：128-132.
[18] Kawai N，Kato H，Kanematsu M，et al. Usefulness of T2*-weighted MRI in the detection of adnexal torsion [J]. Acta Raidol Open，2016，5（6）：2058460116645375.PMCID：PMC4948127
[19] Moribata Y，Kido A，Yamaoka T，et al. MR imaging findings of ovarian torsion correlate with pathological hemorrhagic infarction [J]. J Obstet Gynaecol Res，2015，41（9）：1433-1439.
[20] LeeM H，Meyers N，Raptis CA，et al. Interobserver reliability for computed tomography findings of adnexal torsion [J]. Emerg Radiol，2017，24（1）：21-24.