原发性输卵管癌影像学表现

Imaging findings of primary fallopian tube cancer

目的:探讨原发性输卵管癌(PFTC)的影像学表现,提高对该病的诊断准确性。方法:回顾性分析12例经手术病理证实的PFTC病例,其中9例行CT检查,3例行MRI检查。结果:10例为单侧病灶,2例为双侧病灶。CT表现:输卵管区分叶状或不规则状实性肿块1例;不规则囊实性肿块5例;腊肠形、"C"形实性肿块3例;管状囊性肿块伴管壁软组织结节3例。增强后实性部分轻到中度强化,呈延时强化,囊性部分不强化。MRI表现:实性部分呈稍长T1稍长T2信号,囊性部分呈长T1长T2信号,增强后肿块不均匀强化,实性部分DWI呈高信号。5例伴有输卵管积水。8例患侧子宫圆韧带均匀增粗,走形自然,增强后均匀强化。结论:PFTC典型表现为附件区腊肠样实性肿块,管形囊性肿块伴乳头状突起,伴输卵管积水。患侧子宫圆韧带增粗是PFTC重要的间接征象。

Objective：To investigate the imaging findings of primary fallopian tube carcinoma （PFTC） and to improve the accuracy of preoperative diagnosis. Methods：The imaging datas of CT and MRI of 12 patients with pathologically proved PFTC were retrospectively analyzed. 9 patients were examined by CT and 3 patients were examined by MR imging. Results： Ten of 12 patients with PFTC had unilateral adnexal masses and 2 patients had bilateral masses. Associated CT and MRI imaging findings were solid and lobulated mass （one case） , irregular solid mass with cystic component （five cases）, sau-sage shaped solid mass （three cases）, tubular cystic mass with soft tissue nodules （three cases）and hydrosalpinx （five case）. On CT,after injection of contrast medium,nodes and solid masses enhanced slightly to moderately. Some showed de- layed enhancement. The cystic component showed no enhancement. On MRI, the nodes and solid masses showed moderate signal intensity on T1 WI and T2 WI. The cystic component was hypointense on T1 WI and hyperintense on T2 WI. Tumor was hetergeneously enhanced by gadopentetate dimeglumine. Solid mass and soft tissue nodules were hyperintense on DWI. Eight of 12 patients had thick uterine round ligament. It takes the natural form and homogeneous enhancement. Conclusion： The image manifestations of PFTC are sausage-shaped mass, tubular cystic mass, solid mass and hydrosalpinx. The thicken-ing of ipsilateral uterine round ligament is an important indirect sign.