目的：探讨CT对输卵管平滑肌瘤伴扭转的诊断价值。方法回顾性分析我院近14年来5例经手术、病理证实的输卵管平滑肌瘤伴扭转的临床和CT表现，与1例CT表现极为相似输卵管慢性炎症伴扭转进行鉴别诊断。结果输卵管平滑肌瘤伴扭转与输卵管慢性炎症伴扭转的CT表现有相同之处：呈附件区类圆形肿块，边界清，均伴有出血灶；所有病例近子宫角一侧均可发现喇叭口状或管状病灶，通过多平面重组（MPR）可以发现其与宫角呈带蒂相连。不同之处：输卵管平滑肌瘤伴扭转呈混合性肿块，肿块中间见纤维条索影，增强肿块可不同程度强化，包膜可轻中度强化，其中3例不伴有腹腔积液；输卵管慢性炎症伴扭转呈囊状液性肿块，增强无强化，伴有少量腹腔积液。结论输卵管平滑肌瘤伴扭转非常罕见，临床误诊率非常高，CT在输卵管平滑肌瘤伴扭转的诊断和鉴别诊断中有重要的意义。%Objective To study the CT diagnosis value of tubal leiomyoma with torsion. Methods Differential diagnose the clinical manifestations and CT findings of 5 cases tubal leiomyoma with torsion confirmed by operation and pathology and one very similar tubal chronic inflammation with torsion in the last 14 years in our hospital by ret-rospective analysis. Results The CT findings of tubal leiomyoma with torsion and chronic inflammation with tubal reversal had something in common:adnexal mass,clear boundary, all with hemorrhages;all the case had found the bell shape or tubular in the side near to uterine horn;were found the closely relationship with the pedicle between the lesion and uterine horn for multiple planar reconstruction. The difference: tubal leiomyoma with torsion were found mixed tumor,and the fibrous stripes in the middle, all the lesions were strengthened at different ,and the capsule showed mild to moderate enhancement. Three cases of all without ascites. Chronic inflammation with tubal reversal were found cystic fluid mass,no enhances,with a small amount of ascites. Conclusion Tubal leiomyoma with torsion is very rare, which is very high of the clinical misdiagnosis rate, and the CT finfding are evry important for diagnosis and differential diagnosis the disease.
展开▼
