目的 探讨输卵管卵巢脓肿的 CT、超声表现，探讨影像学技术诊断输 卵管脓肿的价值。方法 回顾性分析医院 37例经手术和病理证实输卵管卵巢脓肿 患者CT、超声诊断资料，对比诊断准确 性，并分析影像学表现。结果 术前CT诊 断准确率为94.58%显著高于超声78.38%， 差异具有统计学意义(P<0.05)；CT影像学 表现为34呈囊性或囊实性，病灶直径为 8cm-15cm，无清晰边界，外缘毛糙。27例 囊壁增厚，大部分囊内存在分隔；大部分 囊壁、囊肿实性静脉期强化有所增强，延 迟扫描时强化持续存在，囊性区无强化表 现，其中8例输卵管扩张，可见囊状影， 呈管状或葫芦状分布；6例囊壁较薄，增 强扫描时持续存在强化特征；3例呈实 性。超声表现为包块大小为3-10cm，位于 子宫后方，无清晰边界，包膜完整；35例 为囊性肿块，内部无回声，有许多点状强 回声呈弥漫性分布；2例为实性包块，包 块内有强回声，呈“蜂窝状”声像图。30 例包块内部可探及血流信号。结论 超声 依然是诊断输卵管卵巢脓肿的首选方式， 但超声显示不清者，可结合CT扫描，提高 诊断准确率。

Objective To investigate the ultrasound and CT findings of tubal ovarian abscess and to explore the value of imaging technique in the diagnosis of tubal abscess. Methods The ultrasound and CT diagnostic data of 37 patients with tubal ovarian abscess confirmed by operation and pathology were retrospectively analyzed. The diagnostic accuracies were compared and the imaging findings were analyzed. Results The preoperative CT diagnostic accurate rate was 94.58% which was significantly higher than 78.38% of ultrasound and the difference was statistically significant (P<0.05). The ultrasound showed that the size of masses was 3-10cm, located posterior to the uterus, without clear boundaries, with complete capsule. There were 35 cases of cystic masses, without internal echo, with many punctiform strong echo showing diffuse distribution. 2 cases were solid masses, with strong echo inside, showing a honeycomb shaped ultrasonogram. There were 30 cases of messes detected with signal of blood flow. CT imaging findings showed that 34 cases were cystic or cystic solid and the lesion diameters were 8cm~15cm, without clear boundaries, with rough edge. 27 cases were vesicle wall thickening and there was separation in most of vesicles. Most of the vesicle walls and cyst solid venous phase were strengthened. When the scan was delayed, the enhancement persisted and there was no enhancement in cystic areas. 8 cases were fallopian tube expansion, with visible cystic shadow which was tubular or gourd shaped distribution. The vesicle walls of 6 cases were thin and when enhancement scan, there were enhancement characteristics persistenting. 3 cases were solid. Conclusion Ultrasound is the first choice for the diagnosis of tubal ovarian abscess and it can be combined with CT scan to improve the diagnostic accuracy.