MRI检查方案对子宫及卵巢肿瘤诊断价值分析

Evaluation of MR Scanning Protocol in Assessment of Female Pelvic Neoplasms

目的:分析和探讨MRI不同成像序列及扫描位置对显示正常女性盆腔结构和诊断盆腔肿瘤的价值,并进一步确定诊断子宫及卵巢肿瘤的最佳MRI检查方案。方法:对20例正常女性盆腔和40例经手术病理证实的子宫或卵巢肿瘤患者的盆腔磁共振成像检查资料进行了定量及定性分析。所有检查均采用SET1WI及FSET2WI序列,分别行横断、矢状及冠状面扫描。在20例患有子宫肿瘤的患者中,11例加做了与子宫腔长轴平行的冠斜位T1WI和T2WI序列扫描。结果:对于正常子宫及直肠的辨别能力,FSET2WI图像明显好于SET1WI图像,两者之间有显著性统计学差异。对于子宫肿瘤患者,分析子宫肿瘤与正常子宫结合带的CNR值,结果表明T2WI图像明显高于T1WI图像且两者之间有显著性统计学差异;联合应用T1WI及T2WI扫描序列在横断、矢状及冠状位对子宫肿瘤的检出准确性分别为64.3%、96.4%、53.6%,且矢状与横断及冠状位之间差异有显著性统计学意义。在11例加做与子宫腔长轴平行的冠斜位患者中,对肿瘤检出及定位、定性的诊断准确性方面,8例(73.0%)显示明显优于其他3种位置。对于卵巢肿瘤的观察结果表明:3种扫描位置的检出能力无明显显著性差异,横断、矢状及冠状位的准确性分别为100%、95%、100%,但对于恶性肿瘤是否伴有髂血管区淋巴结转移及盆壁是否侵犯的观察,

Objective:To optimize the MR scanning protocol in the assessment of uterine and ovarian neoplasms.Methods:Twenty healthy women and40patients with histologically proved pelvic neoplasms underwent MRI scanning using both T 1 -weighted SE and T 2 -weighted FSE sequences in the axial,sagittal and coronal planes.Image sets were assessed with regard to the ability to delineate the uterus,bladder and rectum from adjacent structures.Furthermore,a quantitative assessment of contrast -to -noise ratios between uterine tumors and normal uterine junctional zone was performed for both sequences.Results:Delineation of the uterus and bladder,CNR value between uterine tumors and normal uterine junctional zone were significantly better(P<0.05)on T 2 WI FSE as compared to T 1 WI SE.On the other hand,MR imaging in sagittal plane in detection of urterine tumor with96.4%accuracy was superior to that obtained in axial(with64.3%accuracy)and coronal(with53.6%accuracy)planes.Conclusion:Combined sagittal and oblique planes T 2 WI FSE imaging provided the most optimal scanning protocol in the assessment of uterine tumors.In assessment of suspected ovarian pathologies or parametrial invasion the axial and coronal planes would have been more favourable.