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目的总结分析女性输卵管卵巢脓肿的CT特征,以寻求和探讨鉴别诊断依据及CT诊断的价值。方法回顾性分析10例输卵管卵巢脓肿患者CT腹盆腔增强扫描资料。结果10例患者CT均显示附件区厚壁囊性或囊实混合性肿块,肿块外缘模糊毛糙,增强多见脓肿壁呈厚壁分层强化及内部强化分隔。其他伴随的CT表现子宫骶骨韧带增厚9例,直肠周围、骶前脂肪密度增高模糊9例,显示输卵管扩张积脓或积液的管状结构影6例,宫腔积液4例。CT观察到脓肿与盆腔结构粘连包括肿块与子宫粘连者9例,与直肠、乙状结肠粘连者4例,与盆腔小肠肠管及盆壁结构广泛粘连3例;显示腹膜增厚伴腹水及右侧输卵管卵巢脓肿伴阑尾炎各2例。结论CT除了能观察附件区囊实性肿块,还能显示相邻盆腔器官的受累粘连及盆底软组织或筋膜层的炎性浸润,能对附件脓肿做定性和定位诊断,对诊断不清的可疑妇科感染有鉴别价值。
Objective To summarize and analyze the CT features of female tubal ovarian abscess in order to seek and explore the differential diagnosis basis and the value of CT diagnosis. Methods Retrospective analysis of 10 cases of tubal ovarian abscess CT abdominal pelvic enhancement scan data. Results The CT findings of 10 patients with cystic or cystic solid mass in the attachment area showed that the peripheral edge of the tumor was fuzzy and rough, and the wall of the enhanced abscess was thick-walled stratified enhancement and internal strengthening separation. Other accompanying CT manifestations of uterosacral ligament thickening in 9 cases, around the rectum, presacral fat density increased fuzzy 9 cases, showed tubal empyema or effusion tubular structure in 6 cases, 4 cases of uterine effusion. CT abscess and pelvic adhesions observed in 9 cases, including adhesions and uterine adhesions, and rectum, sigmoid colon adhesions in 4 cases, and pelvic small intestine and pelvic wall structure of extensive adhesions in 3 cases; showed peritoneal thickening with ascites and the right ovarian tubal Abscess with appendicitis in 2 cases. Conclusion CT in addition to observe the cystic masses in the annex area, but also shows the adjacent pelvic organs involved adhesions and infiltration of pelvic floor soft tissue or fascia, qualitative and positional diagnosis of attachment abscess, unclear diagnosis Suspected gynecological infections have differential value.