Twickler D M, Setiawan A T, Evans R S, Erdman W A, Stettler R W, Brown C E, Cunningham F G
Department of Radiology, University of Taxes Southwestern Medical Center, Dallas 75235-8896, USA.
AJR Am J Roentgenol. 1997 Oct;169(4):1039-43. doi: 10.2214/ajr.169.4.9308461.
Our objective was to compare prospectively the abilities of MR imaging, CT, and sonography to reveal puerperal septic thrombophlebitis in the pelvis.
Seventy-six women with puerperal fever for 5 days refractory to antimicrobial therapy underwent MR imaging, CT, and sonography. We obtained unenhanced axial CT images followed by enhanced images after the administration of an oral contrast agent for which we followed a specific protocol. Axial T1- and T2-weighted spin-echo MR images with phase reconstruction and sagittal T1-weighted MR images were obtained. Real-time sonography was performed using Doppler color flow mapping and spectral waveform analysis.
Of the 76 women, 64 completed studies with all three techniques. Ovarian vein thrombosis was diagnosed in 12 women. True-positive results were indicated when at least two of the three studies showed the presence of a clot; true-negative results were indicated when at least two of the three studies showed a lack of thrombosis. MR imaging and CT revealed both ovarian veins in all cases (64/64). Sonography revealed 33 (52%) of 64 right ovarian veins and 15 (23%) of 64 left ovarian veins. MR imaging (sensitivity, 92%; specificity, 100%) and CT (sensitivity, 100%; specificity 99%) were comparable in all but two cases. In one such case, MR imaging showed patency, CT revealed findings interpreted as thrombosis, and sonography showed flow in the partially occluded vein. In the second such case, bilateral thrombosis was seen on CT, but interpretations based on sonography and MR imaging were left-sided thrombosis only. Sonography correctly revealed six of the 12 cases of ovarian vein thrombosis.
CT and MR imaging proved to be the studies of choice in the evaluation of ovarian vein thrombosis.
我们的目的是前瞻性地比较磁共振成像（MR成像）、计算机断层扫描（CT）和超声检查显示盆腔产褥期感染性血栓性静脉炎的能力。
76例抗菌治疗5天仍发热的产褥期妇女接受了MR成像、CT和超声检查。我们先获取未增强的CT轴位图像，然后按照特定方案口服对比剂后获取增强图像。获取了带有相位重建的轴位T1加权和T2加权自旋回波MR图像以及矢状位T1加权MR图像。使用多普勒彩色血流成像和频谱波形分析进行实时超声检查。
76例妇女中，64例完成了所有三项检查。12例妇女被诊断为卵巢静脉血栓形成。当三项检查中至少两项显示有血栓时为真阳性结果；当三项检查中至少两项显示无血栓形成时为真阴性结果。在所有病例（64/64）中，MR成像和CT均显示了双侧卵巢静脉。超声检查显示了64条右侧卵巢静脉中的33条（52%）和64条左侧卵巢静脉中的15条（23%）。除两例病例外，MR成像（敏感性92%；特异性100%）和CT（敏感性100%；特异性99%）在所有方面均相当。在其中一例病例中，MR成像显示通畅，CT显示的结果被解释为血栓形成，而超声检查显示部分闭塞静脉内有血流。在第二例此类病例中，CT显示双侧血栓形成，但基于超声检查和MR成像的判断仅为左侧血栓形成。超声检查正确显示了12例卵巢静脉血栓形成病例中的6例。
CT和MR成像被证明是评估卵巢静脉血栓形成的首选检查方法。
