The Ct Angiography Of Uterine And Ovarian Vessels And Preliminary Clinical Application

Part one. The CT Angiography of the Uterine and Ovarian vessels with64-Detector Spiral CTObject: To evaluate the visualization ratio of the normal uterine artery, ovarian arteryand ovarian vein in adolescence, middle-age, older age with64-detector CT angiography,and to explore the regularity of vessel visualization at different age grades.Materials and Methods: According to age grades,200patients without reproductivesystem disease were collected, divided to adolescent group, middle-aged group, older agedgroup. Divided uterine artery into3segments of close, middle, distal segment to analyze,defined fundus uteri branch (FB), ovarian branch (OB) and cervicovaginal branch (CB) fordistal segment of uterine artery. Using volume rendering (VR), multiplanar reconstruction(MPR) and maximum intensity projection (MIP) to evaluate the visualization ratio of thenormal uterine artery, ovarian artery and ovarian vein.Results: The visualization ratio of close, middle, distal segment of uterine artery wereadolescent group (100%,100%,66.4%), middle-aged group (75.9%,54.5%,10.1%) andolder aged group (17.9%,8.6%,0.7%) respectively. The visualization ratio of OB, FB, CBwere adolescent group (75.7%,67.6%,56.1%), middle-aged group (17.9%,8.9%,3.6%)and older aged group (1.4%,0,0.7%) respectively. The visualization ratio of ovarian arteryin adolescent, middle-aged, older aged group were25.7%,12.5%and5.0%, respectively.The visualization ratio of ovarian vein in adolescent, middle-aged, older aged group were100%,100%,99.6%, respectively.Conclusion: The visualization ratio of uterine artery and ovarian artery in adolescent group were higher than middle-aged, older aged group; there were no difference in thevisualization ratio of ovarian vein.Part two. Value of64-Detector Spiral CT Angiography in diagnosing theorigin and nature of female pelvic neoplasmsObject: To investigate the value of the feeding arteries of tumor and ovarian vein signin diagnosing the origin of female pelvic masses with64-detector CT angiography, and toprobe CTA findings of benign and malignant tumor feeding arteries.Materials and Methods:⑴The enhanced MDCT images of139cases with femalepelvic tumors proved by operation and pathology were reviewed. There were111cases ofovarian tumors and28cases of non-ovarian tumors in this series. The origin of thesetumors was judged by the feeding artery and ovarian vein sign with post-processingtechniques, and analyzed CTA findings of benign and malignant tumor feeding arteries.Results:⑴①Among111cases with126ovarian tumors, the visualization ratio ofovarian artery and ovarian branch was42.9%,61.1%. Among17uterine fibroids, thevisualization ratio of uterine artery branch was88.2%, the incidence rate of ovariancollateral artery was11.8%. Among4cases of broad ligament tumors, the visualizationratio of uterine artery branch was25%. Among4cases of gastrointestinal stromal tumors,the visualization ratio of mesenteric artery was100%. Among3cases of retroperitonealtumors, the visualization ratio of internal or external iliac artery was66.7%.②Thepresence of the ovarian vein sign was identified in88.9%of126ovarian tumors and in7.1%of28non-ovarian tumors.⑵①The sensitivity, specificity, positive predictive value,negative predictive value, and diagnostic accuracy of diagnosing tumor originated fromovary based on ovarian feeding artery was72.2%,92.9%,97.8%,42.6%,76.0%,respectively.②When the ovarian vein sign on helical CT confirmed the ovarian origin, thesensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were88.9%,92.9%,98.2%,65%,89.6%respectively.③The sensitivity,specificity, positive predictive value, negative predictive value, and diagnostic accuracy ofdiagnosing tumor originated from ovary based on tumor feeding artery and ovarian veinsign was96.0%,96.4%,99.2%,84.4%,96.1%, respectively.⑶Except for uterine myomas,CTA findings of female pelvic benign tumor feeding arteries are that the trunk is small, thecourse is regular, the branches are few, there are no obviously reticulate branches, thebranches go along tumor margin or tumor spacer, the enhancement value of tumorparenchyma is not obvious. CTA findings of female pelvic malignant tumor are that thetrunk is thick, the course is circuity, the distribution of tumor solid area blood vessels areunevenness, reticulate, the enhancement value of tumor parenchyma is obvious.Conclusion: MSCT can clearly show the feeding arteries of female pelvic tumor andjudge the relationship of tumor and ovarian vein，which are very helpful in diagnosing theorigin of female pelvic masses. CTA findings of female pelvic tumor feeding arteries havea certain value in diagnosing the nature of female pelvic neoplasms．...