Patel Maitray D, Acord Debra L, Young Scott W
Department of Radiology, Mayo Clinic, 13400 E Shea Blvd., Scottsdale, AZ 85259, USA.
AJR Am J Roentgenol. 2006 Apr;186(4):1033-8. doi: 10.2214/AJR.05.0091.
The objective of our study was to describe the "waist" sign as a feature of hydrosalpinx and to calculate the likelihood ratio of sonographic findings for predicting that a cystic adnexal mass is a hydrosalpinx.
Consecutive institutional records were reviewed to identify patients with surgically excised cystic adnexal masses and preoperative sonograms that had been used to identify the mass. Two radiologists blinded to outcome reviewed the sonograms and recorded the presence of five specific sonographic findings: incomplete septation, short linear projection, small round projection, tubular shape, and presence of a waist. The likelihood ratios of these signs and combinations of signs for the diagnosis of hydrosalpinx were calculated.
There were 55 patients with 67 cystic adnexal masses. Of the 67 cystic adnexal masses, there were 26 hydrosalpinges (39%), 36 cystic ovarian neoplasms (54%), and five paraovarian masses (7%). The likelihood ratios for the sonographic findings were as follows: incomplete septation, 2.1; short linear projection, 3.5; small round projection, 2.7; tubular shape, 10.5; and waist sign, 20.5. The waist sign in combination with tubular shape was found in 12 hydrosalpinges and no other masses (likelihood ratio of between 18.9 and infinity). Small round projection combined with tubular shape was found in 14 hydrosalpinges and one other mass (likelihood ratio of 22.1).
Hydrosalpinx can be diagnosed with the highest likelihood when a tubular mass with the waist sign or a tubular mass with small round projections is encountered. Incomplete septations and short linear projections are less discriminating findings of hydrosalpinx.
我们研究的目的是描述“腰部”征作为输卵管积水的一个特征，并计算超声检查结果预测附件区囊性包块为输卵管积水的似然比。
回顾连续的机构记录，以确定接受手术切除附件区囊性包块且术前超声用于识别该包块的患者。两名对结果不知情的放射科医生检查超声图像，并记录五个特定超声检查结果的存在情况：不完全分隔、短线性突出、小圆形突出、管状形态以及腰部征。计算这些征象及征象组合诊断输卵管积水的似然比。
55例患者有67个附件区囊性包块。在这67个附件区囊性包块中，有26个为输卵管积水（39%），36个为卵巢囊性肿瘤（54%），5个为卵巢冠囊肿（7%）。超声检查结果的似然比如下：不完全分隔为2.1；短线性突出为3.5；小圆形突出为2.7；管状形态为10.5；腰部征为20.5。腰部征与管状形态同时出现见于12例输卵管积水，未见其他包块（似然比在18.9至无穷大之间）。小圆形突出与管状形态同时出现见于14例输卵管积水和1个其他包块（似然比为22.1）。
当遇到有腰部征的管状包块或有小圆形突出的管状包块时，诊断输卵管积水的可能性最高。不完全分隔和短线性突出对输卵管积水的鉴别诊断价值较小。
