3.0T MRI评价原发性卵巢肿块:MRI和DWI对其分类的价值

Evaluation of primary adnexal masses with 3.0T MRI:value of conventional MR imaging and diffusion-weighted imaging in categorization

目的:探讨3T MRI对原发性卵巢肿块的鉴别诊断价值。方法:95个经组织病理学证实的原发性卵巢肿块均行MRI检查,比较良恶性病灶的基本特征、成份以及其在常规MRI和DWI图像的信号特点。结果:本组资料包括18例单纯性卵巢囊肿,22例子宫内膜异位囊肿,26例良性和29例恶性卵巢肿瘤。多数良性肿瘤表现为实性(6/26)和囊性伴有间隔(7/26)。恶性肿瘤(13/29)多表现为囊性伴有实性结节。患者的年龄和肿块的最大径在良、恶性卵巢肿瘤间无统计学显著差异(P=0.339,P=0.082)。在卵巢良性病变和恶性病变间,病灶的传统MRI和DWI信号特点无显著差异(P=0.244,P=0.073),但ADC值在两者间具有统计学显著差异(P=0.000)。结论:3T MRI可以很好地区分原发性附件肿块的信号特点。传统MRI和DWI信号特点无助于鉴别肿块的良、恶性,但ADC值有助于鉴别肿块的良恶性。

Objective：To investigate the MRI characteristics of primary adnexal masses with a 3.0T MR scanner and to study the value for discriminating benign from malignancy. Methods： Ninety-five patients with pathology proven primary adnexal masses,all had MRI scanning preoperatively. The basic MR features, components of mass as well as the signal in tensity characteristics of conventional MRI and diffusion-weighted imaging （DWI） were compared. Results：Of this group, there were ovarian simple cyst （n= 18） ,endometrioma （n=22） ,benign tumour （n= 26） and malignant tumour （n=29）. Intra tumoral solid （6/26） and cystic components with septum （7/26） were assessed in benign tumor, while cyst with intratumoral solid nodules were assessed in malignant tumor （13/29）. There were no significant statistic differences in the age of patient and maximum dimension of tumor between benign and malignant turnouts （P= 0. 339,P =0. 082）. No significant statistic difference in the signal intensities of conventional MRI and DWI between benign and malignancy （P= 0. 244,P= 0. 073） as well. Yet there was significant statistic difference in the mean apparent diffusion coefficient （ADC） values between benign and malignant masses （P= 0. 000）. Conclusions： MR characteristics of primary adnexal lesions could be re vealed with 3.0T MR scanner. Conventional MRI and DWI signals were not useful, yet ADC values were helpful for the differentiation of benign from malignant ovarian tumours.