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目的:分析32例妇科盆腔包块的CT表现,结合手术病理结果,并与B超检查相对比,以提高CT的诊断能力。方法:全部病例均行CT及B超检查,31例行CT增强扫描,30例经手术病理证实,2例经临床随访证实。结果:良性病变23例,分别为子宫肌瘤,囊腺瘤,囊性畸胎瘤,巧可力囊肿,卵巢囊肿,附件炎,子宫内膜息肉,宫外孕等。恶性病变9例,分别为宫颈癌,子宫内膜癌,浆液性囊腺癌,卵巢无性细胞瘤,Krukenberg′s等。CT上主要表现为囊性,囊实性及实性影,良性病灶多为均匀一致密度,与周围境界清楚,可有分隔,部分表现边缘强化。恶性病变多密度不均匀,分界不清,可有腹水,呈不均匀强化。CT定位、定性准确率为100%、93.7%,高于B超(78.1%、65.6%)。结论:CT平扫加增强,能较准确显示病灶的数目、大小、范围、内部结构、与周围的关系及了解良恶性,对制定治疗方案及术后随访有指导意义
OBJECTIVE: To analyze the CT findings of pelvic mass in 32 cases and to compare the results of pathology with those of B-ultrasound to improve the diagnostic ability of CT. Methods: All cases underwent CT and B-ultrasound, 31 cases underwent CT enhanced scanning, 30 cases confirmed by surgical pathology, 2 cases confirmed by clinical follow-up. Results: Twenty-three benign lesions were uterine myoma, cystadenoma, cystic teratoma, clever cyst, ovarian cyst, annex inflammation, endometrial polyps, ectopic pregnancy and so on. Malignant lesions in 9 cases, namely, cervical cancer, endometrial cancer, serous cystadenocarcinoma, ovarian dysgerminoma, Krukenberg’s and so on. CT mainly for cystic, cystic solid and solid shadow, mostly benign lesions are uniform density, with the surrounding realm clearly, may be separated, some of the performance of edge enhancement. Malignant lesions uneven density, unclear boundaries, may have ascites, was unevenly enhanced. The accuracy of CT was 100%, 93.7%, higher than that of B ultrasound (78.1%, 65.6%). Conclusion: CT scan and enhancement can accurately show the number of lesions, size, scope, internal structure, with the surrounding and understand the benign and malignant, to develop treatment options and postoperative follow-up guidance