CT与MR对女性盆腔肿块诊断能力的对比研究

Comparative study of CT versus MRI for diagnosing female pelvic masses

目的分析女性盆腔肿块(FPM)的CT与MRI表现,并比较CT与MRI对FPM的诊断能力。方法50例经手术病理证实的FPM(25例恶性和25例良性)患者均经常规CT与MRI检查。29例又经CT增强扫描,35例又经MRI增强扫描。结果CT正确诊断恶性FPM15例和良性FPM18例,诊断敏感性60%,特异性72%,准确率66%。MRI正确诊断恶性FPM21例和良性FPM22例,诊断敏感性80%,特异性88%,准确率84%。CT增强扫描能显示常规扫描看不到的征象,如卵巢癌壁结节强化和卵巢囊腺瘤的壁与间隔轻度强化等。MRI增强扫描有类似发现。CT对囊性肿块的诊断与MRI相似,对钙化斑的显示优于MRI,但对囊实性肿块结构细节的显示不如MRI。结论CT与MRI的诊断具有各自的优势,总的说来,MRI优于CT,然而,二者结合可明显提高诊断准确率。

Objective To analyse CT and MRI findings of female pelvic masses（FPM）and to compare the diagnostic capability of CT vs MRI for FPMs. Methods Fifty patients with surgically and pathologically proved FPM which comprised 25 malignant and 25 benign cases underwent conventional CT and MRI examinations, 29 patients underwent additional CT enhanced scans, 35 patients underwent additional MRI enhanced scans. Results Among 50 cases, CT correctly diagnosed 15 malignant and 18 benign FPM, the sensitivity, specificity, accuracy were 69%, 72%, 66%, respectively; MRI correctly diagnosed 20 malignant and 22 benign FPM, the sensitivity, specificity, accuracy were 80%, 88%, 84%, respectively. The contrast enhanced CT and MRI scans showed some signs not visible on conventional CT and MR images, for example, enhanced mural nodule of ovarian carcinoma and slightly enhanced walls and septa of ovarian cystadenoma. In the diagnosis of cystic FPM, CT was comparable to MRI, especially in revealing calcified patchy, CT was superior but for revealing the constructive details of cyst - solid masses, it was inferior to MRI. Conclusion CT and MRI have each advantages in the diagnosis of FPM, in general, MRI is superior to CT. However, the integration of CT and MRI can significantly elevate the diagnostic accuracy of FPM.