Fleischer A C, Tait D, Mayo J, Burnett L, Simpson J
Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2675, USA.
J Ultrasound Med. 1998 Sep;17(9):551-5. doi: 10.7863/jum.1998.17.9.551.
Ovarian remnants occur after a portion of ovarian tissue is left behind unintentionally after oophorectomy. The ovarian remnant may be functional and cystic, producing pelvic pain and, in some patients, extrinsic compression of the distal ureter. Ovarian remnants frequently are associated with adhesions from previous pelvic surgery for endometriosis or pelvic inflammatory disease. Ovarian remnants also may be included within pelvic peritoneal inclusion cysts. In this retrospective study, the sonographic features of ovarian remnants in 10 patients with surgical proof or clinical follow-up data are described. Most ovarian remnants were simple cysts (seven of 10), three had multiple septations, and six had a rim of presumably ovarian tissue with arterial and venous flow. Three patients with ovarian remnant masses that were aspirated had symptomatic relief without recurrence. In one patient, guided aspiration was unsuccessful, probably owing to the presence of organized hemorrhage within the mass. Extrinsic compression of the distal ureter was observed in one patient, who was treated with gonadotropin releasing hormone agonist (Lupron). The sonographic findings of a completely cystic or multiseptated pelvic mass with a rim of vascularized solid tissue in a postoophorectomy patient, although such cases are rare, suggest the diagnosis of an ovarian remnant. If the diagnosis can be established with a high degree of certainty, sonographically guided aspiration may be attempted in an effort to provide symptomatic relief. Otherwise, sonography is useful in serial assessment of these masses in patients receiving medical treatment.
卵巢残留是指在卵巢切除术时部分卵巢组织被意外遗留。卵巢残留可能具有功能且呈囊性，会引起盆腔疼痛，部分患者还会出现输尿管远端的外在压迫。卵巢残留常与既往因子宫内膜异位症或盆腔炎行盆腔手术所致的粘连有关。卵巢残留也可能包含在盆腔腹膜包涵囊肿内。在这项回顾性研究中，描述了10例经手术证实或有临床随访数据的患者卵巢残留的超声特征。大多数卵巢残留为单纯囊肿（10例中的7例），3例有多个分隔，6例有一圈可能为卵巢组织的边缘且有动静脉血流。3例对卵巢残留肿块进行抽吸的患者症状缓解且无复发。1例患者引导下抽吸未成功，可能是因为肿块内存在机化性出血。1例患者观察到输尿管远端的外在压迫，该患者接受了促性腺激素释放激素激动剂（亮丙瑞林）治疗。卵巢切除术后患者盆腔内完全囊性或多分隔肿块且边缘有血管化实性组织的超声表现，尽管此类病例罕见，但提示卵巢残留的诊断。如果能高度确定诊断，可尝试超声引导下抽吸以缓解症状。否则，超声对接受药物治疗患者的这些肿块进行系列评估很有用。
