卵巢黏液性交界性肿瘤的MRI表现与病理对照分析

Comparative analysis of MRI findings and pathology of mucinous borderline ovarian tumors

目的探讨卵巢黏液性交界性肿瘤(MBOT)的磁共振成像(MRI)特征并与病理对照。方法回顾性分析22例MBOT患者的临床及MRI资料,所有病例均经手术病理证实,观察肿瘤的位置、大小、成分、分房情况、囊液信号特点、分隔或囊壁厚度和赘生物等,并与病理对照。结果根据MRI形态学表现,将MBOT分为纯囊性16例(72.73%)、囊性伴赘生物4例(18.18%)、囊实性2例(9.09%)3种类型,MBOT特征性表现包括多房性18例(81.82%)、蜂窝状小室15例(68.18%)、异质性囊液信号14例(63.64%)、囊壁或分隔增厚(>5 mm)11例(50.00%)及壁结节或乳头状突起4例(18.18%)。病理上囊液成分出现多样性,按黏度和颜色分为4种:透亮黏液16例(72.73%)、淡黄色黏稠囊液7例(31.82%)、透明黏胨样囊液7例(31.82%)、白色胶样黏稠囊液10例(45.45%)。增厚的囊壁或分隔、结节或乳头状突起呈细小蜂窝状结构。结论MBOT的典型MRI表现为大的多房性囊性肿瘤伴蜂窝状小室或赘生物,囊液信号不均匀,囊壁或分隔增厚。

Objective To investigate the MRI features of mucinous borderline ovarian tumor(MBOT)and to compare with pathology.Methods The clinical and MRI data of 22 MBOT patients confirmed by surgery and pathology in Suizhou Central Hospital were retrospectively analyzed to observe the tumor location,size,composition,compartment,fluid signal,wall and septal thickness,and wall vegetative and other conditions,and they were compared with pathology.Results According to the morphological manifestations of MRI,MBOT was divided into three types:pure cystic(n=16,72.73%),cystic with neoplasms(n=4,18.18%),and cystic firmness(n=2,9.09%).The characteristic MRI manifestations of MBOT included multilocular(n=18,81.82%),honeycomb cells(n=15,68.18%),heterogeneous cystic fluid signal(n=14,63.64%),and thickening of the cyst wall or septum(>5 mm)(n=11,50.00%)and mural nodules or papillae(n=4,18.18%).Pathologically,there was a diversity of cyst fluid components,which were divided into four types according to viscosity and color:Transparent mucus(n=16,72.73%);Yellowish viscous liquid(n=7,31.82%);Transparent sticky peptone extract(n=7,31.82%);White gelatinous viscous liquid(n=10,45.45%).The thickened cyst wall or septum,nodules or papillary projections had a fine cellular structure.Conclusion The typical MRI findings of MBOT are large multilocular cystic tumors with cellular vesicles or vegetations,uneven cyst fluid signal,and thickening of cyst wall or septum.