Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, 30 North 1900 East, #1A071, Salt Lake City, UT, 84132-2140, USA.
Abdom Radiol (NY). 2019 Feb;44(2):697-704. doi: 10.1007/s00261-018-1781-z.
To distinguish the corpus luteum with adjacent ovarian stromal edema as an entity associated with pelvic pain, with confounding ultrasound features that may lead to false-positive diagnosis of ovarian torsion.
This is a blinded, retrospective study of 243 corpora lutea on transvaginal ultrasound. Imaging parameters included ovarian and corpus luteum volumes, central cystic space within the corpus luteum, vascularity around the corpus luteum, peripherally displaced follicles, and complex free fluid. Residual volume (ovarian volume minus corpus luteum volume) was used as a surrogate for ovarian stromal edema. Clinical parameters included age, pregnancy, and location/acuity of pain if present. Concern for ovarian torsion in radiology reports was documented.
51.0% (124/243) of patients presented with pain. Multivariate regression analysis of factors significantly associated with pain (including age, p = 0.001; larger corpus luteum volume, p = 0.002; larger residual volume, p < 0.001; complex free fluid, p = 0.002; and peripherally displaced follicles, p < 0.001) left only increased residual volume as significantly associated with pain [OR 1.02-1.16; p = 0.01]. False-positive concern for ovarian torsion on ultrasound was present in 12.9% (16/124) of patients with pain, associated with enlarged ovaries (p < 0.001) and peripherally displaced follicles (p < 0.001). High correlation between location of pain and side of the corpus luteum was demonstrated in patients with pain < 14 days duration (p < 0.001).
Corpus luteum with ovarian stromal edema is associated with pelvic pain and can mimic ovarian torsion on ultrasound. Further research should explore diagnostically useful differences between cases of ovarian torsion and cases of ovarian edema related to corpora lutea.
将黄体与邻近卵巢间质水肿区分开来，黄体与盆腔疼痛有关，其混淆的超声特征可能导致卵巢扭转的假阳性诊断。
这是一项经阴道超声检查的黄体 243 例的盲法、回顾性研究。成像参数包括卵巢和黄体体积、黄体中央囊性空间、黄体周围血管、周边移位卵泡和复杂游离液。残留体积（卵巢体积减去黄体体积）用作卵巢间质水肿的替代物。临床参数包括年龄、妊娠以及存在疼痛时的疼痛位置/严重程度。记录放射学报告中对卵巢扭转的关注。
51.0%（124/243）的患者出现疼痛。多因素回归分析与疼痛显著相关的因素（包括年龄，p=0.001；更大的黄体体积，p=0.002；更大的残留体积，p<0.001；复杂的游离液，p=0.002；和周边移位卵泡，p<0.001）仅留下残留体积的增加与疼痛显著相关[比值比 1.02-1.16；p=0.01]。疼痛患者中超声假阳性对卵巢扭转的关注为 12.9%（16/124），与卵巢增大（p<0.001）和周边移位卵泡（p<0.001）有关。疼痛持续时间<14 天的患者中疼痛部位与黄体侧之间显示出高度相关性（p<0.001）。
黄体伴卵巢间质水肿与盆腔疼痛有关，在超声上可模拟卵巢扭转。应进一步研究卵巢扭转和与黄体相关的卵巢水肿病例之间有诊断意义的差异。
