多囊卵巢综合征

2020

04/20

腹部医学影像论坛

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HISTORY: A 31-year-old female with a history of irregular menses

病史：女，31岁，月经不规律。

FINDINGS:

Pelvic ultrasound and T2-weighted MRI demonstrates an enlarged ovary with >12 subcentimeter peripheral follicles surrounding a prominent hyperechoic (US) and hypointense (MRI) ovarian stroma. No evidence of dominant follicle.

影像表现：盆腔超声和MRI T2WI显示卵巢增大，周围囊泡大于12亚厘米。周围卵巢基质在超声上强回声，MRI上低信号。未见优势卵泡。

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DIAGNOSIS:

Polycystic ovary syndrome (PCOS)

诊断：多囊卵巢综合征

DISCUSSION:

Also known as Stein-Leventhal syndrome, PCOS is one of the most common causes of female infertility. PCOS is an endocrinologic disorder characterized by chronic anovulation and hyperandrogenism. Furthermore, PCOS has a classic triad of obesity, amenorrhea, and hirsutism; but only half of patients present with this combination.

讨论：多囊卵巢综合征也叫S-L综合征。是女性不孕的最常见原因。主要是由于内分泌紊乱导致长期无排卵和雄激素分泌过盛。PCOS典型三联征：肥胖、闭经和多毛症。但仅有半数患者表现为此三联症。

Therefore, imaging evaluation tends to follow to gain further information . Typical US/MRI findings include enlarged, rounded ovaries with numerous small, peripherally located follicles and stroma showing increased echogenicity (US) or decreased signal on T2-weighted imaging (MRI). Long-term follow-up should be recommended in such patients as PCOS patients have an increased risk of breast and uterine cancer secondary to unopposed high estrogen levels .

因此，需采用影像检查进一步获取更多信息。典型的超声/MRI征象包括：卵巢增大、变圆，外周多发小囊泡，卵巢基质US上强回声，T2WI低信号。PCOS患者建议长期随访，因长期雌激素水平过高，可能会继发乳腺癌和子宫癌。

（以上主题节选自腹部影像病例汇）

Notes:

1. Polycystic ovary syndrome [ˌpɑliˈsɪstɪk ˈovəri ˈsɪnˌdrom] 多囊卵巢综合征

2. menses ['mensi:z] n. 月经

3. peripheral [pəˈrɪfərəl] adj. 外周的

4. follicles n. 小囊

5. hyperechoic [haɪpɪre'kɔɪk] 强回声的

6. infertility [ˌɪnfɚˈtɪlɪti] n. 不育

7. endocrinologic 内分泌的

8. anovulation [ænɒvjʊ'leɪʃn] n. 停止排卵

9. hyperandrogenism [haɪpə'rændrɒdʒɪnɪzəm] 雄激素过多症