【摘要】 目的 探讨妇科急腹症的CT与MRI表现及其诊断价值。方法 回顾性分析45例经手术证实的妇科急腹症患者CT与MRI征象,异位妊娠17例,卵巢囊肿破裂10例,卵巢肿瘤蒂扭转6例,输卵管卵巢脓肿、盆腔炎9例,子宫破裂、穿孔3例。31例行CT检查,14例行MRI检查,39例为平扫加增强扫描。结果 17例异位妊娠表现为附件区厚壁囊性或混杂密度/信号肿块,10例周围血管增多并见强化的血管伸入肿块内;10例卵巢囊肿破裂病例中7例囊壁强化不完整呈开环状,囊腔塌陷;6例卵巢肿瘤蒂扭转病例中4例可见同侧不规则团块状增粗的瘤蒂,2例卵巢明显肿大,伴周围卵泡排列呈“水果盘”征;9例输卵管卵巢脓肿、盆腔炎病例中6例可见蜂窝状、多房状改变,5例输卵管呈腊肠样扩张;3例子宫破裂、穿孔均表现为宫腔内积气、积液,2例宫旁气体外溢伴周围包裹,1例发现子宫壁菲薄、连续性中断。结论 CT与MRI检查除了可以明确妇科急腹症的病因外,还能多方位显示盆腔组织器官解剖结构关系及病理变化表现,对妇科急腹症的诊断有非常重要的价值。更多还原

【Abstract】 Objective To explore the manifestations and diagnostic value of CT and MRI in gynecological acute abdomen.Methods CT and MRI features of 4 5 patients with gynecological acute abdomen proved by surgery were reviewed,including 17 ectopic pregnancy,10ovarian cyst rupture,6 pedicle torsion of ovarian tumors,9 tubo-ovarian abscess and pelvic inflammation and 3 uterine perforation.31cases underwent CT examination,14 cases underwent MRI examination and 39 cases underwent non-enhancement and enhancement scanning.Results In the 17 cctopic pregnancy cases,cystic structure surrounded by a thick wall or heterogeneous mass located in adnexal area was found,with 10 cases showing increased number of peripheral vessels penetrating into tumors.In the 10 cases with rupture of ovarian cyst,thick capsule wall was incomplete and cystic cavities collapsed in 7 lesions.In the 6 cases with pedicle torsion of ovarian tumors,irregular thickening of tumor pedicle were found in 4 cases,ovarian enlargement with surrounding follicles arrayed as fruit platter were found in 2 cases.In the 9 cases with tubo-ovarian abscess and pelvic inflammation,honeycomb-shaped lesions and multilocular changes were found in 6 cases and fallopian tube expanded like sausages in 5 cases.3 cases with uterine perforation exhibited intrauterinc gas and fluid.Uterus with overflowed gas was found in 2 cases.One case had the thin and incomplete uterine wall.Conclusion CT and MRI can be used to confirm the causes of gynecological acute abdomen,and to comprehensively display the anatomical structures and pathological changes of pelvie tissues and organs.Therefore,CT and MRI arc effective supplement means for the clinical diagnosis of gynecological acute abdomen.更多还原