Stikkelbroeck Nike M M L, Hermus Ad R M M, Schouten Diana, Suliman Harold M, Jager Gerrit J, Braat Didi D M, Otten Barto J
Department of Paediatric Endocrinology, University Medical Centre Nijmegen, P.O. Box 9101, Nijmegen, The Netherlands.
Eur Radiol. 2004 Oct;14(10):1802-6. doi: 10.1007/s00330-004-2329-x. Epub 2004 Aug 18.
The aim of the investigation was to assess the prevalence of ovarian adrenal rest tumours and polycystic ovaries in female patients with congenital adrenal hyperplasia (CAH). Thirteen female CAH patients (median age 19.8 years, range 14.8-23.5 years) underwent transvaginal (n=6) or transabdominal (n=7) ultrasonography by a gynaecologist and MR imaging (n=13) of the ovaries (pre and post contrast-enhanced T1- and T2-weighted images). Ovarian adrenal rest tumours were defined as small hypoechoic and multifocal nodules on ultrasound and isointense lesions on T1- and hypointense on T2-weighted MR images (derived from characteristics of testicular adrenal rest tumours). Polycystic ovaries were defined as the presence of > or = 10 follicles arranged peripherally around or scattered throughout increased stroma. No ovarian adrenal rest tumours were found either on ultrasound, or by MR imaging. Polycystic ovaries were found in 2 of the 13 patients (15.4%), both with ultrasound and MR. No ovarian adrenal rest tumours were detected in these female CAH patients, which suggests that ovarian adrenal rest tumours in CAH females are rare. The prevalence of polycystic ovaries corresponded to that in the general population. From these results, we would suggest that routine ovarian imaging in CAH females is not indicated. However, when ovarian dysfunction is present, ovarian imaging is advised, first by ultrasonography, to detect ovarian adrenal rest tumours or polycystic ovaries.
本研究的目的是评估先天性肾上腺皮质增生症（CAH）女性患者中卵巢肾上腺残余瘤和多囊卵巢的患病率。13例CAH女性患者（中位年龄19.8岁，范围14.8 - 23.5岁）由妇科医生进行经阴道超声检查（n = 6）或经腹超声检查（n = 7）以及卵巢的磁共振成像（n = 13）（对比增强前后的T1加权和T2加权图像）。卵巢肾上腺残余瘤定义为超声检查时的小低回声和多灶性结节以及T1加权磁共振图像上等信号病变和T2加权磁共振图像上低信号病变（源自睾丸肾上腺残余瘤的特征）。多囊卵巢定义为在增厚的间质周围或散在分布有≥10个卵泡。超声检查或磁共振成像均未发现卵巢肾上腺残余瘤。13例患者中有2例（15.4%）通过超声和磁共振成像发现有多囊卵巢。这些CAH女性患者中未检测到卵巢肾上腺残余瘤，这表明CAH女性中的卵巢肾上腺残余瘤很罕见。多囊卵巢的患病率与普通人群相当。根据这些结果，我们建议不应对CAH女性进行常规卵巢成像检查。然而，当出现卵巢功能障碍时，建议首先通过超声检查进行卵巢成像，以检测卵巢肾上腺残余瘤或多囊卵巢。
