The B ultra involvement ovary cyst puncture pours into the ethyl alcohol curative effect analysis / 中国基层医药

Objective To discuss the curative effect under the B ultra involvement the ovary cyst puncture to pour into the ethyl alcohol treatment ovary cyst.Methods 66 examples ovaries cyst were handlled as follows:in front of the technique the B ultra prompt for the ovary pure cyst or the chocolate cyst,cyst diameter ≤7cm,the application involvement supersonic technology,after the abdominal wall or the vagina the dome good puncture,puncture needle arrives the pouch cavity,extracted the liquid,after the right amount physiological saline flushing pouch cavity,poured into 95% ethyl alcohol quantity for the pouch for the fluid amount of space occupied 1/3～1/2 quantities.Results The 66 examples patients technique latter 1 month,half year,one year,two years reexaminations,the cyst vanished in 60 examples,reduced in 6 examples,after the cyst vanished no case recured curing rate reached 906%.Conclusion Among the ovary cyst puncture the treatment of pouring into the ethyl alcohol has a good curative effect,operation simple,wound small,non-surgery illness complication.

Corpus Luteum Cyst Rupture - US Findings and Clinical Features

PURPOSE: To describe the US findings of corpus luteum cyst rupture in order to elucidate the associated clinical features. MATERIALS AND METHODS: Twenty patients with proven corpus luteum cyst rupture were included in this study. The US findings of these patients were retrospectively analyzed in terms of the presence of designable cyst, size of the cyst, thickness and blood flow of the cyst wall, extension and echogenicity of peritoneal fluid, and involved site (right or left ovary). We also surveyed the clinical features such as the onset period according to the menstrual cycle, and the presence of suspectable cause. RESULTS: Fourteen of the 20 patients revealed designable cysts (mean diameter of 2.6 cm) with thick walled cysts (mean thickness, 4.6 mm, 2.4 -6.8 mm) and increased blood flow. Six patients didn 't reveal any cyst but only hematoma in adnexa. All patients had hemoperitoneum in the pelvic cavity, and the hemoperitoneum was extended to Morrison's pouch in 8 patients and to the subphrenic space in 6. The cysts occurred in the right adnexa in 15 patients and in the left in 5. Mean interval from the last menstrual period (LMP) was 26 days (13-44 days) and 6 of the 8 patients for whom it had been possible to obtain detailed history taking had had coitus just before the occurrence of symptom. CONCLUSION: When women who are hospitalized for acute abdomen and who are in luteal phase reveal US findings of hematoma or thick-walled cyst in adnexa and hemoperitoneum, a corpus luteum cyst rupture is highly suspected. In our case study the corpus luteum cyst rupture predominantly occurred in the right side, and the most suspectable cause was trauma such as coitus in the luteal phase.

Huge Endometrioma Mimicking Mucinous Cystadenoma on MR: A Case Report

Endometriosis is a relatively common gynecologic disease affecting women during their reproductive years. For its diagnosis, magnetic resonance imaging has been shown to have greater specificity than other modalities. Although lesions may show variable signal intensity due to numerous stages of bleeding, the characteristic finding of endometrioma which distinguishes it from other ovarian cystic masses is relatively high signal intensity on T1-weighted images and heterogeneous signal intensity with prominent shading on T2-weighted images. We report an atypical case involving a huge endometrioma. Because of varying signal intensity on T1- and T2-weighted images and scanty shading on T2-weighted images, the findings were misinterpreted and mucinous cystadenoma was diagnosed.

Sclerotherapy of Peritoneal Inclusion Cysts: Preliminary Results in Seven Patients

OBJECTIVE: To evaluate the technical feasibility and the clinical effectiveness of sclerotherapy for the treatment of peritoneal inclusion cysts (PICs). MATERIALS AND METHODS: Between June 1996 and February 2001, eight PICs in seven female patients aged 28-43 (mean, 36) years were instilled with sclerosant (povidone-iodine in three, ethanol in three, both povidone-iodine and ethanol in one). All seven patients subsequently experienced less abdominal pain. After drainage via an 8.5-Fr pigtail catheter inserted in the PICs (transabdominally in six cases, transvaginally in one), sclerosant equivalent in volume to about one-third that of drained fluid was introduced daily until the drained volume was less than 5ml. Follow-up by means of clinical procedures and ultrasound was performed every three months, at which time the success rate, possible complications and recurrence were determined. RESULTS: Sclerotherapy was technically successful in all seven patients, though immediately after the procedure, minor complications were noted in three patients (mild pain in two, mild fever in one). During the follow-up of 4-60 (mean, 24.7) months, sclerotherapy proved successful and without long-term complications in all seven patients: lower abdominal pain disappeared and the diameter of the cysts decreased more than 50%, with complete regression in four cases. During the follow-up period there was no recurrence. CONCLUSION: Sclerotherapy following catheter insertion is technically feasible and effective for the treatment of PICs.

Tetracycline Hydrochloride Sclerotherapy: Renal, Hepatic, Ovarian, and Perivesical cysts

PURPOSE: To assess the efficacy and resulting complications of tetracycline sclerotherapy in renal, hepatic, ovarian, and perivesical cysts. MATERIALS AND METHODS: We retrospectively reviewed 23 cases of benign cysts (16 renal, 4 hepatic, 2 ovarian, and 1 perivesical) in 22 patients in whom the condition was diagnosed or confirmed by either ultrasound, CT, or cytology, and who underwent percutaneous tetracycline sclerotherapy. Using a 21-gauge Chiba needle, the target cyst was punctured under ultrasound guidance. Prior to the injection of 1500 mg of tetracycline diluted in 5 ml of normal saline, almost all the cystic content was aspirated, and at the end of the procedure the tetra-cycline was left in the cyst. During a period of between 3 and 22 months, 18 of the 23 cases were followed up. RESULT: In six of the 18 cases followed up, the cysts either decreased in size by 10%, or collapsed completely. In seven cases a collapse of over 50% was noted, and in the remaining five the cyst recurred. In one of these, complete collapse occurred after retreatment at ten months, and the patient with a perivesical cyst underwent surgery six months after recurrence. Thus, treatment was effective (a collapse of at least 50%) in 13 of 18 cases (72.2%). This total of 13 comprised ten of 12 renal cysts (83.3%), two of two ovarian (100%), and one of three hepatic (33.3%). Percutaneous therapy was unsuccessful in five cases (two hepatic cysts, one renal, one para-pelvic and one perivesical). Complications occurring during the procedure or follow-up period included discomfort or mild pain, vomiting, and transient fever, though these subsided within 24 hours. In one patient with severe pain, this subsided after four days. CONCLUSION: As single-shot injection of tetracycline provides safe and effective treatment for renal and ovarian cysts, but for hepatic cysts is unsuccessful.

MR Findings of Struma Ovarii

PURPOSE: To characterize the magnetic resonance (MR) findings of struma ovarii, a rare ovarian tumor composedsolely or predominantly of thyroid tissue or the tumor in which hyperthyroidism results from the ovarian thyroidtissue. MATERIALS AND METHODS: In seven patients, MR images (T1-weighted with or without gadolinium enhance-mentand T2-weighted) were obtained in the axial, coronal, and sagittal planes using 1.5-T MR units, and in three ofseven patients the fat saturation technique were performed. MR findings were retrospectively evaluat-ed for thesite, size, components, signal intensity, presence and degree of contrast enhancement, and associat-ed findings.These and pathologic findings were compared. RESULTS: MR images showed unilateral complex masses composed ofmultiple cysts and some solid components, corresponding pathologically to thyroid follicles containing colloid andthe stroma with abundant blood vessels and fibrous tissue. Cystic portions of the tumors had variable signalintensities on T1-weighted images, and high signal intensities on T2-weighted images. Some hyperintense cysticareas seen on T1-weighted images were due to hemorrhage (n=1) and colloid components (n=3). Solid portions of thetumors were isointense relative to adjacent muscles (with intense contrast enhancement), as seen on T1-weightedimages, and iso- or hyperintense on T2-weighted images. CONCLUSION: Struma ovarii has a characteristic MRappearance of a complex mass composed of multiple cysts and intensely enhanced solid components.

MR Imaging Differentiation of Endometrial Cysts from Hemorrhagic Cysts

PURPOSE: To differentiate endometrial cysts from hemorrhagic cysts on the basis of MR findings MATERIALS AND METHODS: The MR findings of twelve patients with endometrial cysts(15 cases) and of nine patients withhemorrhagic cyst(12 cases) were retrospectively evaluated. Fourteen patients were surgically corfirmed and sevenwith hemorrhagic cysts were clinically diagnosed by resolution of the cysts during ultrasound follow up. Sixteenpatients underwent MR imaging using a 1.5T system(Magnetom Vision, Siemens, Germany), and for five patients a 2.0Tsystem(Spectro 2000, Goldstar, Korea) was used. MR images were retrospectively evaluated with respect to size andsignal intensity of the cyst, uni/multilocularity, shading, the hematocrit effect, clot.., fluid-fluid level andseptum, and thickness, signal intensity and enhancement of the cyst wall. RESULT: Eleven(73.3%) endometrial cystswere multilocular, but all hemorrhagic cysts were unilocular. The signal was hyperintense on both T1WI and T2WI inten(66.7%) endometrial cysts and seven(58.3%) hemorrhagic cysts. Shading was found in five(33.3%) and one(8.3%),respectively; the hematocrit effect in two(13.3%) and five(41.7%) respectively, clot in two of each type(13.3%,16.7%), and fluid-fluid level in only one hemorrhagic cyst. Septum was found only in endometrial cysts(five cases,33.3%); its signal intensity on both T1WI and T2WI was low, and on Gd-enhanced images was not enhanced. The cystwall was thick in five of each type(33.3%, 41.7%); its signal intensity was low on both T1WI and T2WI, and notenhanced on Gd-enhanced images. In eight hemorrhagic cysts, however, the cyst wall was iso to high in signalintensity on both T1WI & T2WI, and was enhanced on Gd-enhanced images. The prevalence of uni/ multilocularity,septum, and signal intensity and the presence of enhancement of the cyst wall were significantly different between the two groups(p< 0.005). CONCLUSION: Uni/ multilocularity, septum, and signal intensity and enhancement of thecyst wall were useful for the differentiation of endometrial from hemorrhagic cysts. Signal intensity of the cyst,shading, the hematocrit effect and clot were not helpful.

Radiologic Findings of Struma Ovarii

PURPOSE: Struma ovarii is ovarian tumor composed solely or predominantly of thyroid tissue or tumor in which hyperthyroidism results from ovarian thyroid tissue, and usually occurs in tandem with cystic teratoma. Ovarian cystic teratoma is radiologically easily diagnosed due to calcification or fat, for example, but the preoperative diagnosis of struma ovarii is often difficult due to rare characteristic features of thyroid tissue. Our purpose was to determine whether there were specific findings of struma ovarii which distinguished it from other ovarian tumors, and this involved analysis of its radiologic findings. MATERIALS AND METHODS: Using ultrasonography, computed tomography, and magnetic resonance imaging, preoperative radiologic findings of pathologically-proven struma ovarii in eleven patients were retrospectively evaluated for site, margin, nature (cystic, solid, mixed), contrast enhancement, septa, mural nodule, calcification, fat, and metastasis. These findings were compared with pathologic findings. RESULTS: All eleven tumors were unilateral, ten had smooth tumor margins, seven were mixed cystic and solid tumors (more than 70% of solid components in one tumor), and nine had regular septa. Three of four cystic masses (one unilocular, one bilocular and two multilocular cysts) had mural nodules. Calcifications were found in two tumors, and fat in one. Malignant change or metastasis was not found in any tumor. In one patient with hyperthyroidism due to struma ovarii, symptoms and signs of this subsided after removal of the tumor on salpingo-oophorectomy. CONCLUSION: Most cases of struma ovarii occurred unilaterally within ovarian teratomas in premenopausal women, and were mixed cystic and solid masses with smooth margins that are commonly enhanced on contrast enhanced scans. In one patient, hyperthyroidism was caused by struma ovarii. There were, however, no specific radiologic findings that were sufficiently typical to suggest the correct preoperative diagnosis of struma ovarii.

CT Findings of Endometrioma: Differential Points from Other Benign Complex Cystic Adnexal Masses

PURPOSE: To evaluate whether CT scanning is useful in differentiating the between endometriomas and other benign complex cystic adnexal masses, and in determining the method of treatment for each mass lesion. MATERIALS AND METHODS: In 54 cases (47 patients), we retrospectively analysed the CT findings of 20 pathologically-proven twenty endometriomas (bilateral in four cases), eight hemorrhagic functional cysts, two tubal ectopic pregnancies, eight tubo-ovarian abscesses (bilateral in two cases), ten serous cystadenomas (bilateral in one case), and six mucinous cystadenomas. Internal attenuation, the hyperdense portion, adhesion, and cul-de-sac obliteration were evaluated by CT scanning. RESULTS: Fourteen endometriomas (70%) showed a hyperdense portion, and in only two of these (10%), was a focal nodular hyperdense portion seen on pre-contrast CT scan (10% sensitivity, 100% specificity). Partial or complete cul-de-sac obliteration was identified in 11 patients (75%), while hemorrhagic functional cysts showed a hyperdense portion in four cases (50%) and were accompanied by partial cul-de-sac obliteration in two (25%). Two unruptured tubal ectopic pregnancies showed CT findings of unilateral hyperdense cystic masses of more than 60 HU. In all cases, tubo-ovarian abscesses were accompanied by thickening of the uterosacral ligament and deviation of thickened mesosalpinx (anterior deviation in 87.5% of patients). Serous and mucinous cystadenomas showed CT findings of hypodense masses (less than 20 HU) without adhesion or cul-de-sac obliteration, and this was helpful in differentiating cystadenomas from other benign cystic adnexal masses, including endometriomas. CONCLUSION: The evaluation by CT scanning of benign complex cystic adnexal masses with respect to the hyperdense portion and the presence or absence of cul-de-sac obliteration was usful in differentiating endometriomas from other lesions, and might be helpful in determining the method of treatment for each mass lesion.

Endometrial Carcinoma Occuring from Polycystic Ovary Disease: A Case Report

Endometrial carcinoma usually occurs in postmenopausal women ; less than 5% occurs in women under the age of40. Up to one quarter of endometrial carcinoma patients below this age have PCO(polycystic ovary disease, Stein-Leventhal syndrome). The increased incidence of endometrial carcinoma in patients with PCO is related to chronic estrogenic stimulation. We report MR imaging in one case of endometrial carcinoma occuring in a 23 yearold woman with PCO and had complained of hypermenorrhea for about three years. On T2-weighted MR image the endometrial cavity was seen to be distended with protruded endometrial masses of intermediate signal intensity, and the junctional zone was disrupted beneath the masses. Both ovaries were best seen on T2-weighted MR imagingand showed multiple small peripheral cysts and low signal-intensity central stroma.