女性盆腔肿瘤的MRI诊断和评价

MRI Diagnosis and Evaluation for Female Pelvic Neoplasms

目的 分析和总结女性盆腔肿块在MRI上的表现 ,评价Gd DTPA对肿瘤诊断的意义。阐述MRI在女性盆腔疾患诊断和鉴别诊断中的作用。材料与方法 65例女性盆腔肿块患者 ,年龄 18天～ 85岁 ,平均 5 1岁。 47例同时行增强扫描。结果 ( 1)来源于生殖系统肿块包括子宫肌瘤 10例 ,子宫内膜癌 4例 ,宫颈癌 2例 ,卵巢囊肿 7例 ,卵巢子宫内膜异位 6例 ,卵巢囊腺瘤 5例 ,畸胎瘤 11例 ,卵巢癌 9例 ,卵巢卵泡膜细胞瘤 2例 ,输卵管系膜囊肿、卵巢纤维瘤各 1例。 ( 2 )来源于生殖系统外的肿块有胃癌种植转移5例 ,盆腔淋巴瘤、乙状结肠癌、直肠平滑肌肉瘤各 1例。部分患者兼有上述病变的 1～ 2项。结论 ( 1)原发于生殖系统的肿瘤在女性盆腔肿块中最常见。 ( 2 )MRI良好的软组织对比分辨率、任意方位成像使之能很好地显示病变的组织学特性 ,对畸胎瘤、子宫肌瘤、子宫内膜异位、卵巢囊肿、卵巢囊腺瘤等病变可作定性诊断。其MRI诊断的手术符合率可达 10 0 %。 ( 3 )腹水、肿瘤乳头状壁结节、液化坏死等恶性肿瘤征象有时也可存在于良性肿瘤 ,应加以鉴别 ,谨防过度诊断。 ( 4 )良恶性肿瘤均可有明显强化 ,不能单纯根据强化率来判断病灶的性质。但Gd DTPA增强改善了肿瘤内部结构的显示及肿瘤与周围组织的关系 ,对恶性肿瘤的?

Objective To analyze and summarize the MRI features of female pelvic masses, to evaluate Gd DTPA administration in diagnosing pelvic tumors.Materials and Methods MRI findings of female pelvic masses in 65 patients, aged 18 days～85 years with a mean of 51 years, were retrospectively analyzed.Results Of 65 pelvic tumors, 56 were originated from genital system.Conclusion (1) Most female pelvic masses are originated from genital system. (2) Enhancement can occur in both benign and malignant pelvic tumors, which are of non specific. Thus, determination of the pathology can not be relied on tumor enhancement. (3) Tumors, such as teratoma, endometriosis, uterine leiomyoma, ovarian cyst, cystadenoma, etc. have some characteristic signals on MRI, with which 100% diagnostic accuracy may be obtained. (4) Some so called malignant features of tumors, such as necrosis, ascites and cystic wall nodules, can also be found in benign tumors. (5) It is difficult to distinguish metastatic tumors from primary ones.