卵巢浆液性乳头状囊腺癌的临床特点及MRI影像表现分析

Analysis of the Clinical Features and MRI Findings of Ovarian Serous Papillary Cystadenocarcinoma

目的分析卵巢浆液性乳头状囊腺癌临床特点及MRI影像学特征。方法收集2011年2月-2015年9月我院收治的36例卵巢浆液性乳头状囊腺癌患者的临床及影像学资料,所有患者均经手术病理确诊,且入院后已完成MRI检查,且影像学资料完整,总结其临床特征及MRI影像学表现。结果 36例卵巢浆液性乳头状囊腺癌,MRI见形态不规则,盆腔内信号不规则,可见不均匀囊性、囊实性肿块;肿瘤直径(11.3±5.6)cm;单房15例,多房21例;20例伴盆腹腔积液;囊液T1WI见均匀水样信号27例,呈等信号或高信号9例,T2WI序列呈不均匀高信号;囊壁厚度(2.5±1.1)cm;增强扫描见囊壁强化27例;MRI分型:Ⅰ型0例,Ⅱ型36例,其中Ⅱa型15例,Ⅱb型16例,Ⅱc型5例,1例Ⅰ型误诊为Ⅱa型,分型准确率为97.22%。结论卵巢浆液性囊腺癌多为囊实性,双侧型多见,常侵犯周围组织,伴远处转移,大多数伴腹水,周围血管异常增多,分隔、囊壁增厚,增强扫描明显强化是卵巢浆液性囊腺癌典型MRI特点。

Objective To analyze the clinical features and MRI findings of ovarian serous papillary cystadenocarcinoma. Methodsethods The clinical and imaging data of 36 patients with ovarian serous papillary cystadenocarcinoma who were treated in our hospital between February 2011 and September 2015 were collected. All patients were confirmed by operation and pathology. MRI examination was performed after admission, and the imaging data were complete. The clinical features and MRI findings were summarized. Results In 36 cases with ovarian serous papillary cystadenocarcinoma, MRI showed irregular shape, irregular signals in the pelvic cavity, inhomogeneous cystic and cystic solid masses. The tumor diameter was（11.3±5.6） cm. There were 15 cases with single cavity, 21 cases with multiple cavity and 20 cases with pelvic and peritoneal effusions. There was homogeneous water-like signal on cystic fluid T1 WI in 27 cases, equal signal or high signal in 9 cases, and inhomogeneous high signal on T2WI; The cystic wall thickness was（2.5±1.1） cm. Enhanced scan showed cystic wall enhancement in 27 cases. In terms of MRI typing, there was 0 case of type I, 36 cases of type II, including 15 cases of type IIa, 16 cases of type IIb and 5 cases of type IIc. One case was misdiagnosed as type IIa, and the accuracy rate was 97.22%. Conclusion Most ovarian serous cystadenocarcinomas are cystic and solid, bilateral type. They often invade surrounding tissues, with distant metastases, mostly complicated with ascites. They＇ll increase peripheral abnormal vascular vessels, separated and cystic wall thickening. Enhanced scan showing obvious enhancement is the typical MRI finding of ovarian serous cystadenocarcinoma.