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目的探讨输卵管卵巢脓肿(tuboovarian abscess,TOA)的低场MRI表现及诊断价值。资料与方法回顾性分析经手术病理证实的26例TOA患者的MRI资料。结果 26例33个TOA,表现为附件区厚壁囊性或囊实性肿块,边界不清,囊内见多房分隔,肿块呈等长T1、长T2信号,信号欠均匀。其中24个脓肿伴积脓或积液扩张的输卵管管状结构,表现为弯曲长管状、“腊肠”状、“糖葫芦”状或“曲颈瓶”状。增强扫描脓肿实性及分隔部分明显强化,囊壁强化,壁厚2.5~20 mm。脓肿与子宫粘连21例,直肠乙状结肠粘连13例,骶前直肠周围脂肪水肿17例,单侧或双侧子宫骶骨韧带增厚15例,盆腔小肠、肠系膜、大网膜及盆壁结构广泛增厚粘连9例。正确诊断30个(90.9%),误诊卵巢癌1例,卵巢巧克力囊肿2例。结论 TOA具有特征性低场MRI表现。低场MRI是一种较理想的检查方法 ,具有较高的诊断价值。
Objective To investigate the low-field MRI findings and diagnostic value of tuboovarian abscess (TOA). Materials and Methods MRI data of 26 TOA patients confirmed by surgery and pathology were retrospectively analyzed. Results Twenty-six TOAs were performed in 33 cases with thick cystic or cystic mass in the appendix. The border was unclear. The multi-atrial septum was seen in the cysts. The tumors showed equal length T1 and long T2 signals with undeveloped signals. Among them, 24 abscess tubal structures with empyema or effusion dilated showed long curved tubular shape, “sausage” shape, “candied fruit” shape or “curved neck flask” shape. Enhanced abscess solidity and separation of part of the marked enhancement, wall enhancement, wall thickness of 2.5 ~ 20 mm. Abscesses and uterine adhesions in 21 cases, 13 cases of rectosigmoid adhesions, presacral and rectal fat edema in 17 cases, unilateral or bilateral uterosacral ligament thickening in 15 cases, pelvic small intestine, mesentery, omentum and pelvic wall structure thickening Adhesion in 9 cases. The correct diagnosis of 30 (90.9%), misdiagnosed ovarian cancer in 1 case, ovarian chocolate cyst in 2 cases. Conclusion TOA has characteristic low-field MRI findings. Low-field MRI is a more ideal method of examination, with high diagnostic value.