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目的探讨女性附件扭转的MRI表现特征。方法回顾性分析26例经手术病理证实的附件扭转患者的影像学资料,均行超声和MRI检查,并与手术结果对照分析。结果本组26例中,输卵管系膜囊肿扭转3例,其中1例继发卵巢蒂扭转;输卵管积水伴扭转1例;原发性卵巢扭转4例,卵巢肿物伴蒂扭转18例。MRI确诊23例,漏误诊3例,诊断准确率约88.5%(23/26),高于同期超声诊断准确率65.4%(17/26)。26例患者的MRI均显示盆腹腔内异常信号肿块,并与一侧宫角或附件相连。2例婴幼儿子宫小、显示不清。扭转蒂呈鸟嘴征12例,结节征或漩涡征12例,结构紊乱2例。漩涡征或鸟嘴征在DWI序列见局部高信号9例(9/10)。增强扫描扭转蒂内见迂曲或漩涡样血管强化7例(7/7)。本组26例中,发生扭转的肿物共27个:囊性肿物16个,囊实性肿物11个。在T2WI及SPIR序列上,囊壁或分隔不规则增厚12例,液-液平面7例,囊实性肿块均为混杂信号。同时合并盆腔积液11例,妊娠4例,子宫肌瘤4例,对侧卵巢畸胎瘤1例,对侧卵巢内膜样囊肿1例,对侧输卵管积水1例。结论女性附件扭转的MRI表现具有特征性,是超声检查的有益补充。
Objective To investigate the MRI features of female attachment torsion. Methods A retrospective analysis of 26 cases of pathologically confirmed attachment torsion in patients with imaging data were performed by ultrasound and MRI, and the results of the controlled analysis. Results Of the 26 cases, tubal mesangial cyst was reversed in 3 cases, including 1 case of secondary ovarian pedicle torsion, 1 case of tubal hydrops with torsion, 4 cases of primary ovarian torsion and 18 cases of ovarian mass accompanied by pedicle torsion. Twenty-three cases were diagnosed by MRI and 3 cases were misdiagnosed. The diagnostic accuracy rate was 88.5% (23/26), which was higher than 65.4% (17/26) in the same period. Twenty-six patients had abnormal pelvic signals in the pelvis and were associated with the cornual or accessory on the side. 2 cases of infants and young children uterine small, unclear. Tixi nibbling sign in 12 cases, nodules or vortex sign in 12 cases, structural disorder in 2 cases. Vortex signs or beak sign in the DWI sequence, see the local high signal in 9 cases (9/10). Enhanced scan to reverse see Tyndan or vortex-like vascular enhancement in 7 cases (7/7). The group of 26 cases, a total of 27 cases of torsion of the tumor: cystic mass 16, cystic solid tumor 11. In T2WI and SPIR sequences, there were 12 cases of irregular wall or segmental thickening, 7 cases of liquid-liquid level, and cystic solid tumors were all mixed signals. Concurrent pelvic fluid in 11 cases, 4 cases of pregnancy, 4 cases of uterine fibroids, contralateral ovarian teratoma in 1 case, contralateral ovarian endometrioid cysts in 1 case, contralateral tubal water in 1 case. Conclusion The MRI findings of torsion of females are characteristic and useful for ultrasonography.