超聲診斷卵巢卵黃囊瘤伴巧克力囊腫的表現及臨床價值分析

郝美嘉 范靜 柯偉

【摘要】目的：探討卵巢的內胚竇瘤伴發巧克力囊腫的超聲檢查聲像圖特征性的表現，以提高超聲對其診斷的準確率。方法：回顧性的分析2003年3月至2014年11月期間于我院經手術以及病理確認為卵巢的卵黃囊瘤伴發巧克力囊腫的37例超聲資料，探討其超聲圖像表現，同時與手術以及病理檢查的結果進行對比，以分析其臨床診斷價值。結果：37例的研究病歷中，13例呈現實質性的回聲，局部還可以見到蜂窩樣的改變，22例呈囊實性的改變以及2例呈現囊性多房，同時實質部分還可以檢出豐富的血流信號；此外，巧克力囊腫內部回聲多樣化，依據病程長短以及月經周期而不同，具有一定的特征性；超聲對于卵黃囊瘤伴巧克力囊腫的診斷正確率達到86.5%。結論：卵巢的卵黃囊瘤伴發巧克力囊腫的超聲圖像具有一定的特征性，了解和認識卵黃囊瘤以及巧克力囊腫的超聲圖像特點，結合患者的年齡、血清中甲胎蛋白的水平等可提高相應的診斷率，對于臨床診斷具有重要價值。

【關鍵詞】卵巢；卵黃囊瘤；巧克力囊腫；表現；價值

Performance and clinical value of ultrasound diagnosis of ovarian yolk sac tumor and chocolate cystHAO Meijia1， FAN Jing2， KE Wei3. 1. Department of Ultrasound， Hubei Zhongshan Hospital， Wuhan 430033， Hubei， China； 2. Department of Obstetrics and Gynecology， Hubei Zhongshan Hospital， Wuhan 430033， Hubei， China； 3. Department of Cardiology， Hubei Zhongshan Hospital， Wuhan 430033， Hubei， China

【Abstract】Objectives： To explore the characteristic performance of ultrasound image about ovarian yolk sac tumor and chocolate cyst in ovary， in order to improve the diagnosis accuracy. Methods： Retrospective analysis of the ultrasound data of 37 patients confirmed by surgery and pathology of ovarian yolk sac tumor and chocolate cyst in our hospital from March 2003 to November 2014 was conducted to investigate its performance of ultrasound images. Comparison with the surgical and pathological results was carried out to analyze its clinical diagnostic value. Results： In the 37 cases， 13 cases presented substantial echo with local cellular change； 22 cases had cystic changes and 2 cases presented cystic multilocular. Rich blood flow signals can also be detected in the substantial portion. Besides， Chocolate cysts internal echo was diverse and varied on the basis of duration of disease and the menstrual cycle， with certain characteristics. The diagnosis correct rate of yolk sac tumor and chocolate cyst with ultrasound was 86.5%. Conclusions： The ultrasound image of ovarian yolk sac tumor and chocolate cyst is of certain characteristics. Knowledge of the ultrasound images characteristics of yolk sac tumor and chocolate cyst helps improving the diagnostic yield corresponding when combining with the patients age， serum alpha-fetoprotein levels， which is of great value for clinical diagnosis.

【Key words】Ovary； Yolk sac tumor； Chocolate cyst； Performance； Value

【中圖分類號】R737.31；R445.1【文獻標志碼】A

卵巢的卵黃囊瘤又被稱為內胚竇瘤，是臨床上一種比較少見的主要發生于兒童以及年輕婦女的生殖系統惡性腫瘤，預后比較差，一般情況下3年的存活率僅僅有13%[1]。盡管對于卵黃囊瘤的病理以及臨床特征已經有比較全面的報道了[2]，但是對于其影像學方面的描述還是很少的，同時也是不全面的。……