Feng Jie-Ling, Lei Ting, Xie Hong-Ning, Li Li-Juan, Du Liu
Department of Ultrasonic Medicine, Fetal Medical Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
J Ultrasound Med. 2017 Sep;36(9):1859-1866. doi: 10.1002/jum.14225. Epub 2017 May 8.
To investigate the role of ultrasound in the preoperative diagnosis of adnexal torsion and describe its histological spectrum and outcomes at different ages.
This study comprised a retrospective investigation of a data set that included 195 female patients with clinically suspected adnexal torsion between January 2010 and July 2015. Each patient received a detailed pelvic ultrasound examination by an experienced ultrasound examiner, and a definitive diagnosis was achieved via surgery. The accuracy of an ultrasonic diagnosis of adnexal torsion was assessed. The patients were divided into three groups: female children and adolescents, fertile women, and postmenopausal women. The size, type, histological spectrum, and outcome of adnexal torsion in the different groups were also described.
The sensitivity, specificity, and accuracy of ultrasound were 0.84, 0.77, and 0.81, respectively. There were significant differences in the presence of ultrasonic hallmarks among the true positive, false positive, and false negative cases of adnexal torsion. Ovarian torsion was identified in 94 cases, and isolated tubal torsion was identified in 15 cases. The most common histologic diagnoses of the pediatric group and the other two groups were a normal ovary and teratoma, respectively. The most common histologic diagnoses in the cases of isolated tubal torsion were mesosalpinx cyst and oviduct inflammation.
Ultrasonography plays an important role in the preoperative diagnosis of adnexal torsion. Despite ovarian involvement in most of the cases, isolated oviduct torsion was not uncommon. The spectrum of histological diagnoses varied among the age groups.
探讨超声在附件扭转术前诊断中的作用，并描述其在不同年龄阶段的组织学特征及转归。
本研究对2010年1月至2015年7月间195例临床疑似附件扭转的女性患者数据集进行回顾性调查。每位患者均由经验丰富的超声检查医师进行详细的盆腔超声检查，并通过手术获得明确诊断。评估超声诊断附件扭转的准确性。将患者分为三组：女童及青少年、育龄妇女和绝经后妇女。还描述了不同组中附件扭转的大小、类型、组织学特征及转归。
超声的敏感性、特异性和准确性分别为0.84、0.77和0.81。附件扭转的真阳性、假阳性和假阴性病例中超声特征的存在情况存在显著差异。94例诊断为卵巢扭转，15例诊断为单纯输卵管扭转。儿科组和其他两组最常见的组织学诊断分别为正常卵巢和畸胎瘤。单纯输卵管扭转病例中最常见的组织学诊断为输卵管系膜囊肿和输卵管炎。
超声检查在附件扭转的术前诊断中起着重要作用。尽管大多数病例累及卵巢，但单纯输卵管扭转并不少见。不同年龄组的组织学诊断谱有所不同。
