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目的探讨多层螺旋CT在输卵管卵巢脓肿及输卵管积水诊断中的价值。方法选取该院2014年10月-2016年10月诊治的输卵管卵巢脓肿患者57例和输卵管积水患者51例,均行阴道超声检查和多层螺旋CT检查,后经手术病理确诊,分析多层螺旋CT的诊断价值。结果输卵管卵巢脓肿患者的多层螺旋CT表现:患者表现为厚壁肿块,肿块壁厚度在2.4~7.1 mm,平均肿块壁厚度为(4.3±1.6)mm,内壁清楚,但边界较模糊,增强扫描后,呈分层状强化或均匀强化,而液性部分无强化,肿块周围可见脂肪密度增高及条索影。输卵管卵巢脓肿患者的阴道超声表现:患者存在脓肿,包块大小为3~8 mm,位于子宫后方,无清晰边界,包膜完整,囊性肿块患者内部无回声,实性包块患者内部强回声,并呈蜂窝状声像图,部分患者可探及血流信号,呈点状或细条状分布,阻力值为0.54~0.71。输卵管积水患者的多层螺旋CT表现:患者表现为管状、腊肠状、多囊状或囊状肿块,壁厚度在1.3~1.7mm,平均肿块壁厚度为(1.5±0.2)mm,壁光整清楚,增强扫描后,周围未见炎症反应。输卵管积水患者的阴道超声表现:单侧或双侧附件可见大小、形态不一或迂曲的无回声团块,可呈腊肠状或曲颈瓶形,包块有较强回声的薄壁边缘,囊内壁多不光滑,内部无回声,输卵管黏膜皱襞相互粘连,输卵管积水扭曲可呈不全分隔的强回声带,分隔之间液性暗区相通,无回声团块的管壁和不全分隔可探及少量血流信号,内部无回声时无血流信号。输卵管卵巢脓肿患者多层螺旋CT的诊断准确度(98.24%)高于阴道超声(85.96%);输卵管积水患者多层螺旋CT的诊断准确度(98.04%)高于阴道超声(86.27%),差异有统计学意义(χ2=5.911、4.883,均P<0.05)。结论多层螺旋CT是输卵管卵巢脓肿及输卵管积水的有效诊断方法,优于阴道超声检查。
Objective To investigate the value of multislice spiral CT in the diagnosis of tubal ovarian abscess and hydrosalpinx. Methods Fifty-seven patients with tubal ovarian abscess and 51 patients with tubal hydrops who were diagnosed and treated from October 2014 to October 2016 in our hospital were examined by vaginal ultrasonography and multi-slice spiral CT. After operation and pathology, 57 Diagnostic value of spiral CT. Results The results of multislice spiral CT in patients with tubal ovarian abscess showed that the patients showed thick-walled mass with the thickness of 2.4 ~ 7.1 mm and the mean mass of the wall of 4.3 ± 1.6 mm, the internal wall was clear, but the boundaries were faint and enhanced After the layered enhancement or even enhanced, and no enhancement of the liquid part of the mass visible around the lumps of fat density and shadow film. Vaginal ultrasound findings in patients with tubal ovarian abscess: abscess in patients with mass size of 3 ~ 8 mm, located in the rear of the uterus, no clear boundaries, complete capsule, cystic lumps within the patient without echo, solid masses within the patient’s strong echo , And was honeycomb sound image, some patients can explore and blood flow signal was dotted or strip-like distribution, the resistance value of 0.54 ~ 0.71. Tubal hydronephrosis in patients with multi-slice spiral CT manifestations: the performance of patients with tubular, sausage-like, cystic or cystic mass, the wall thickness of 1.3 ~ 1.7mm, the average mass of wall thickness (1.5 ± 0.2) mm, Clear, enhanced scan, no inflammation around the response. Vaginal hydrops in patients with tubal ultrasound: unilateral or bilateral attachment size, shape or tortuous anechoic mass can be sausage-shaped or trachoma bottle-shaped, mass with a strong echogenic thin-walled edge, More than smooth inner wall of the capsule, no echo within the tubal mucosal folds mutual adhesions, hydrosalpinx may show incomplete separation of the strong echo zone, separated by the liquid dark area interlinked, non-echo mass wall and incomplete separation of exploration And a small amount of blood flow signal, no blood flow within the echo-free signal. The accuracy of multi-slice spiral CT in diagnosis of tubal ovarian abscess was 98.24% higher than that of vaginal ultrasound (85.96%). The diagnostic accuracy of multi-slice CT in tubal hydrops (98.04%) was higher than that of vaginal ultrasound (86.27%), The difference was statistically significant (χ2 = 5.911,4.883, both P <0.05). Conclusion Multi-slice spiral CT is an effective diagnostic method for tubal ovarian abscess and hydrosalpinx, which is superior to vaginal ultrasound examination.