Kubik-Huch R A, Hebisch G, Huch R, Hilfiker P, Debatin J F, Krestin G P
Department of Radiology, University Hospital, Rämistrasse 100, CH-8091 Zürich, Switzerland.
Abdom Imaging. 1999 Jan-Feb;24(1):85-91. doi: 10.1007/s002619900448.
Septic puerperal ovarian vein thrombosis (SPOVT) is one of the underlying etiologies of puerperal fever. A correct diagnosis of this condition is important because adequate treatment requires additional administration of anticoagulants. The purpose of this study was to evaluate the role of duplex color Doppler ultrasound (CDUS), computed tomography (CT), and magnetic resonance angiography (MRA) in the detection of SPOVT.
Twenty-six patients with puerperal fever suspected to be due to SPOVT and unresponsive to broad antibiotic treatment for at least 48 h were included in a prospective study using CDUS, CT, and MR imaging including MRA. Examinations were analyzed and then correlated to a standard of reference gathered from surgical and clinical follow-up data and from results of imaging.
SPOVT was present in nine patients (right side n = 8, bilateral n = 1). CDUS was inconclusive due to gaseous distention of the bowel or obesity in 13 of 26 cases. After counting inconclusive findings as wrong results for statistical purposes, sensitivity, specificity, and accuracy for CDUS were 55.6%, 41.2%, and 46.2%, respectively. CT had a sensitivity of 77.8% with a specificity of 62.5%; accuracy was 68.0%. MRA rendered conclusive results in all evaluated patients, resulting in a sensitivity and specificity of 100%.
MRA is recommended in all patients with inconclusive CDUS findings and persistent suspicion for SPOVT. CT has the advantage of more rapid access and lower cost and thus will probably remain a sufficiently accurate alternative. Septic puerperal ovarian vein thrombosis (SPOVT)-Computed tomography-Magnetic resonance angiography-Ultrasound.
产褥期感染性卵巢静脉血栓形成（SPOVT）是产褥热的潜在病因之一。正确诊断该疾病很重要，因为充分的治疗需要额外使用抗凝剂。本研究的目的是评估双功彩色多普勒超声（CDUS）、计算机断层扫描（CT）和磁共振血管造影（MRA）在检测SPOVT中的作用。
26例疑似因SPOVT导致产褥热且对广泛抗生素治疗至少48小时无反应的患者纳入一项前瞻性研究，使用CDUS、CT以及包括MRA在内的磁共振成像。对检查结果进行分析，然后与从手术和临床随访数据以及影像学结果收集的参考标准进行关联。
9例患者存在SPOVT（右侧8例，双侧1例）。26例中有13例因肠道气体扩张或肥胖导致CDUS检查结果不明确。为了统计目的将不明确的结果计为错误结果后，CDUS的敏感性、特异性和准确性分别为55.6%、41.2%和46.2%。CT的敏感性为77.8%，特异性为62.5%；准确性为68.0%。MRA在所有评估患者中均得出明确结果，敏感性和特异性均为100%。
对于CDUS检查结果不明确且仍高度怀疑SPOVT的所有患者，建议进行MRA检查。CT具有检查更快速、成本更低的优势，因此可能仍是一种足够准确的替代方法。产褥期感染性卵巢静脉血栓形成（SPOVT）-计算机断层扫描-磁共振血管造影-超声。
