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中华妇幼临床医学杂志(电子版) ›› 2011, Vol. 07 ›› Issue (06) : 540 -545. doi: 10.3877/cma.j.issn.1673-5250.2011.06.007

论著

卵巢血管蒂征在女性盆腔肿块CT诊断中的定位价值
陈荟竹, 宁刚, 曲海波, 叶川, 李学胜, 王祖莉   
  1. 610041 成都,四川大学华西第二医院放射科
  • 出版日期:2011-12-01

Location Value of the Ovarian Vascular Pedicle Sign on Multidetector CT in Female With Large Pelvic Masses

Hui-zhu CHEN, Gang NING, Hai-bo QU, Chuan YE, Xue-shen LI, Zu-li WANG   

  1. Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Published:2011-12-01
  • Supported by:
    * Project No. 05S011-019-1, supported by Key Technologies R & D Program of Sichuan Province; project No.09H0653, supported by the Yi Yao Foundation of Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
引用本文:

陈荟竹, 宁刚, 曲海波, 叶川, 李学胜, 王祖莉. 卵巢血管蒂征在女性盆腔肿块CT诊断中的定位价值[J/OL]. 中华妇幼临床医学杂志(电子版), 2011, 07(06): 540-545.

Hui-zhu CHEN, Gang NING, Hai-bo QU, Chuan YE, Xue-shen LI, Zu-li WANG. Location Value of the Ovarian Vascular Pedicle Sign on Multidetector CT in Female With Large Pelvic Masses[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2011, 07(06): 540-545.

目的

探讨利用盆、腹腔多排螺旋CT(MDCT)研究卵巢静脉及卵巢血管蒂征(OVPS)对于女性盆腔肿瘤来源的诊断价值。

方法

选择2006年10月至2011年4月在本院临床诊断为妇科肿瘤的患者297例为研究对象。采取回顾性分析法,对其按照MDCT观察双侧OVPS结果,将其分为病例组(n=208,卵巢来源肿瘤累及侧卵巢)和对照组(n=386,非卵巢来源肿瘤累及侧卵巢+健侧卵巢)。采用MDCT测量双侧卵巢静脉的最大短径,以病理学检查结果为诊断金标准,对OVPS进行诊断性试验。

结果

①OVPS判断盆腔肿瘤为卵巢来源的敏感度、特异度、阳性预测值及阴性预测值分别为97.60%(203/208),92.75%(358/386),87.88%(203/231)和98.62%(358/363),准确率为94.44%(561/594),与术后卵巢组织病理学检查结果比较,差异有统计学意义 (P<0.005);②单侧卵巢肿瘤患者的健侧与患侧卵巢静脉直径比较,差异有统计学意义(P<0.05)。

结论

OVPS对于判断女性盆腔肿块是否来源于卵巢,或来源于哪一侧卵巢的定位价值高,而卵巢静脉直径判断盆腔肿瘤的定位诊断价值较低。

Objective

To explore the use of the ovarian vascular pedicle sign(OVPS) as well as the diameters of ovarian veins to differentiate the fmales with a large pelvic mass on multidetector CT (MDCT).

Methods

In our study, from October 2006 to April 2011, we elected 297 patients, who had clinical diagnosis of gynecological tumor in our hospital. We observed retrospectively whether there was OVPS or not in each case with MDCT, and divided into patient group (n=208, the source of ovarian tumor involving the side) and the control group (n=386, non-ovarian source of ovarian tumors involving the side + the uninjured side). We measured the diameter of bilateral ovarian vein with MDCT. The pathological results was served as the golden standard, and diagnostic test was performed for OVPS.

Results

①Compared with the pathological results, results show that the presence of OVPS on MDCT was statistically significant (P<0.005) to differentiate the source of the ovarian tumor, and the sensitivity, specificity, positive predictive value and negative predictive value were 97.60%(203/208), 92.75%(358/386), 87.88%(203/231), 98.62%(358/363), and diagnostic accuracy rate was 94.44%(561/594). ② there was significant difference in the diameter of the ovarian veins between the mass side and contralateral side in the patients with an ovarian mass.

Conclusion

OVPS plays an important role in locating the source of ovarian tumor in females with a large pelvic mass. and the value of the diameter of the ovarian veins in differentiating ovarian origin or not was low.

图1 卵巢静脉直径诊断卵巢来源与非卵巢来源盆腔肿瘤的ROC曲线
图2 左卵巢卵黄囊瘤(女性,12岁)(A:卵黄囊瘤横断面,B:卵黄囊瘤MIP冠状位,C:卵黄囊瘤MIP矢状位,均示左侧卵巢血管蒂征)
图3 左卵巢低分化宫内膜样腺癌(女性,55岁)(A:腹主动脉左侧增大淋巴结、左卵巢静脉及左肾静脉;B:左侧卵巢血管蒂征)
图4 双侧卵巢成熟性囊性畸胎瘤双侧示卵巢血管蒂征(女性,39岁)
1 Jiang L,Zhen TL,Lou JR,et al. The diagnostic value of ovarian vein imaging with MSCT in the genital system tumorous[J] Xinjiang Med J,2010,(3):17-19.[蒋黎,郑田玲,楼俭茹,等. MSCT卵巢静脉成像在生殖系统肿瘤的诊断价值[J]. 新疆医学,2010,(3): 17-19.]
2 Ye chuan,Ning gang,Qu hai bo,et al. Ovarian vascular pedicle sign in female with large pelvic masses: Value in differentiating ovarian origin or not[J]. Sichuan Univ (Med Sci Ed),2010,41(2):348-350.[叶川,宁刚,曲海波,等. 卵巢血管蒂征对于卵巢和非卵巢来源肿瘤的鉴别诊断价值[J].四川大学学报:医学版,2010,41(2): 348-350.]
3 Ning gang. genital system and mammary gland. Zhou Xiang Ping, ed. Medical image [M].Beijing: Higher Education Press,2008,351-386.[宁刚.生殖系统与乳腺.周翔平,主编.医学影像学[M].北京:高等教育出版社,2008,351-386.]
4 Jong HL,Yoong KJ,Ji KP, et al.Ovarian vascular pedicle sign revealing organ of origin of a pelvic mass lesion on helical CT[J]. AJR,2003, 7:131-137.
5 Yoshitake Y, Asayama K,Yoshimitsu, et al. Bilateral ovarian leiomyomas: CT and MRI features[J].Abdom Imag, 2005,30:117-119.
6 Kim SH, Sim JS, Seong CK. Interface vessels on color/power Doppler US and MRI: A clue to differerntiate subserosal uterine myomas from extrauterine tumors[J]. J Comput Assist Tomogr, 2001, 1:36-42.
7 Shigeaki U, Takashi K, Kaori T, et al. Vascular dilatation in the pelvis: Identification with CT and MR imaging[J]. Radio Graphics, 2004, 24:193-208.
8 Faysal AS, Samuel CF. Recognition of the ovaries and ovarian origin of pelvic masses with CT[J]. Radio Graphics,2004, 24:133-146.
9 Shao ZH,Wang PJ,Zheng SQ,et al. MSCT anatomy of ovary and its clinical value[J]. J Clin Radiolog, 2007,26(5):481-483.[邵志红,王培军,郑少强,等. 卵巢的多层螺旋CT解剖及其临床意义[J]. 临床放射学杂志,2007,26(5) :481-483.]
10 Tadao H, Takeshi N, Seiko N, et al. Reflux in the left ovarian vein:Analysis of MDCT findings in asymptomatic women[J].AJR,2004,11:1411-1415.
11 Rozenblit AM, Ricci ZJ, Tuvia J, et al. Incompetent and dilated ovarian veins: A common CT finding in asymptomatic parous women[J]. AJR,2001,176:119-122.
12 Yoshiki A, Kengo Y, Hitoshi A, et al. MDCT of the gonadal veins in females with large pelvic masses: Value in differentiating ovarian versus uterine origin[J].AJR, 2006, 186:440-448.
13 Yuan DH, Chen SH. Value of gonadal veins in differentiating large ovavian and uterine tumor[J] J China Clin Med Imag,2008,19(1):68-70. [袁德华,陈绍红. 性腺静脉对较大卵巢和子宫肿瘤的鉴别诊断价值[J]. 中国临床医学影像杂志,2008,19(1):68-70.]
14 Szklaruk J,Tamm EP,Choi H, et al. MR imaging of common and uncommom large pelvic masses[J]. Radio Graphics, 2003,23:403-424.
15 Mclean JM. Embryology and anatomy of the ovaries. Fox H, Wells M, ed. Haines and taylor obstetrical and gynaecological pathology. 4th ed[M]. New York, NY: Churchill Livingstone, 1995,673-698.
16 YUAN De-hua. Angiography and clinical significance of the gonadal veins on multi-slice CT[J]. J Med Imag, 2009,19(7):888-891. [袁德华.性腺静脉MSCT血管成像及其临床意义[J].医学影像学杂志,2009,19(7):888-891.]
17 Mittl RLJ, Yeh IT, Kressel HY. High-signal-intensity rim surrounding uterine leiomyoma on MR images: Pathologic correlation[J]. Radiology, 1991, 180:81-83.
18 Torashima M, Yamashita Y, Matsuno Y, et al. The value of detecton of flow voids between the uterus and the leiomyoma with MRI[J]. J Magn Reson Imaging,1998, 8:427-431.
19 Cranstron PE,Tumer JH,Morano JU. Pseudothrombosis of the right ovarian vein[J]. Clin Imag,1995,19:176-122.
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