Serafini G, Quadri P G, Gandolfo N G, Gandolfo N, Martinoli C, Derchi L E
Servizio di Radiologia, Ospedale di Pietra Ligure, Via XXV Aprile 128, Pietra Ligure (SV) I-17027, Italy.
J Clin Ultrasound. 1999 Sep;27(7):369-73. doi: 10.1002/(sici)1097-0096(199909)27:7<369::aid-jcu2>3.0.co;2-n.
We describe the transvaginal sonographic features of incidentally detected, small, nonpalpable ovarian dermoid cysts.
A total of 38 small (less than 3 cm in diameter), nonpalpable, incidentally discovered ovarian dermoids in 35 women were retrospectively reviewed; 3 patients had small bilateral lesions, and 7 had a small ovarian dermoid detected during preoperative evaluation of a symptomatic, large, contralateral lesion.
Transvaginal sonography permitted identification of all 38 dermoids, whereas abdominal sonography detected only 22 of the lesions. Three main structural patterns were observed with transvaginal sonography: (1) 20 of 38 lesions had a solid, hyperechoic appearance, either homogeneous (11) or heterogeneous (9); (2) a fluid-filled area with a hyperechoic focus in its wall was seen in 10 cases; and (3) a mixed pattern, with solid and liquid areas, was seen in 8 cases. Calcifications were appreciated in 7 lesions. Acoustic shadowing was noted in 30 cases, either as a shadow posterior to the hyperechoic portion of the mass or as an edge shadow lateral to the lesion. Doppler studies were obtained for 20 lesions but proved inconclusive: 4 mixed-pattern dermoids had a few internal signals with a low resistance pattern; in the remaining cases, there were signals at the periphery of the cysts, but it could not be determined whether these were from vessels within the lesions or from vessels in the surrounding ovarian parenchyma. Surgery confirmed benign cystic dermoids in all 38 cases.
Sonographically, small ovarian dermoids have a variety of textural patterns quite similar to those encountered in large, symptomatic lesions. The increased resolution capabilities provided by transvaginal sonography allow incidental detection of previously unsuspected dermoids and permit identification of their nature.
我们描述偶然发现的、较小的、不可触及的卵巢皮样囊肿的经阴道超声特征。
回顾性分析35例女性中38个偶然发现的、较小（直径小于3 cm）、不可触及的卵巢皮样囊肿；3例患者有双侧小病灶，7例在有症状的对侧大病灶术前评估时发现小的卵巢皮样囊肿。
经阴道超声能够识别所有38个皮样囊肿，而腹部超声仅检测到22个病灶。经阴道超声观察到三种主要结构模式：（1）38个病灶中有20个表现为实性、高回声，呈均匀（11个）或不均匀（9个）；（2）10例可见壁内有高回声灶的液性区；（3）8例为实性和液性区混合模式。7个病灶可见钙化。30例可见声影，表现为肿块高回声部分后方的阴影或病灶外侧的边缘阴影。对20个病灶进行了多普勒研究，但结果不明确：4个混合模式皮样囊肿有少量内部信号，呈低阻力模式；其余病例中，囊肿周边有信号，但无法确定这些信号是来自病灶内的血管还是周围卵巢实质内的血管。手术证实所有38例均为良性囊性皮样囊肿。
超声检查中，小的卵巢皮样囊肿有多种质地模式，与大的有症状病灶所见非常相似。经阴道超声提高的分辨率能够偶然发现先前未怀疑的皮样囊肿并确定其性质。
