放射影像（五十四）卵巢扭轉的影像表現

10.6666/ClinMed.2017.79.1.011

邱乃祈；陳怡仁

卵巢扭轉 ； 卵巢畸胎瘤 ； 卵巢懸韌帶

臨床醫學月刊

79卷1期（2017 / 01 / 27）

61 - 64

繁體中文

卵巢扭轉是臨床婦產科腹痛原因之一，指供應卵巢的血管發生扭轉，使血流供應異常，導致卵巢缺血，甚至卵巢壞死破裂，引起劇烈腹痛。多見於年輕女性，臨床表現如劇烈腹痛、噁心、嘔吐等。手術為主要處理方式。臨床鑑別診斷包含急性闌尾炎、泌尿結石等。影像上最常見但特異性不高的表現是，卵巢腫大，病側卵巢最大直徑超過4公分。特異性高的影像表現是：腫大卵巢的中間實質，因為出血和水腫，看不到濾泡；濾泡都被推擠到腫大卵巢的邊緣。扭轉的卵巢懸韌帶，是最有特異性的影像特色，但只出現在三分之一的電腦斷層或磁振造影檢查影像中。因為卵巢懸韌帶的結構及走向，重組的冠狀切面或矢狀切面的影像較容易偵測出變化。

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