MRI在卵巢囊腺癌的诊断价值

The diagnostic value of MRI in ovarian cystadenocarcinoma

目的：探讨 MRI 在卵巢囊腺癌（简称卵腺癌）中的诊断价值。方法选择我院2010年1月-2013年1月确诊的卵巢囊性病变患者131例资料进行回顾性分析,以手术后病理结果为金标准,其中良性囊性病变71例,卵巢囊腺癌60例,患者手术及病理确诊前均行 MRI 检查,观察 MRI 在卵腺癌诊断中的敏感性和特异性,分析卵腺癌的 MRI 征象。结果所有患者经 MRI 诊断,均准确定位,其中附件区75例,子宫上方54例,子宫前方2例；定位诊断准确率为100%,直径在2.5-38.9 mm。MRI 诊断卵巢囊性腺瘤69例,卵巢囊性腺癌62例,浆液性囊腺癌39例,黏液性囊腺癌23例,与病理结果（良性71例,恶性60例）比较,诊断敏感性为88.33%（53/60）,特异性为92.96%（66/71）。卵巢囊腺癌以Ⅱ型为主,占91.36%,卵巢囊腺瘤患者以Ⅰ型为主,占73.91%,良恶性病变分型差异具有统计学意义（P 〈0.05）。62例MRI 诊断为卵巢囊腺癌患者中单发13例,占20.97%,多发49例,占79.03%,MRI 表现为盆腔内信号、形态不规则、不均匀的囊性、囊实性、囊实性肿块；T1WI 呈等或高、低混杂信号,T2WI 呈不均匀高信号,22例患者行增强扫描显示,囊性部分无强化,囊内无强化,实性部分有中度或明显强化。囊性肿块囊壁呈不规则增厚,囊内 T1WI 呈低或高信号, T2WI 呈高信号。62例均有腹水征。结论 MRI 可准确对卵巢囊性病变作进行定位,并可准确显示肿块形态、大小及侵及范围,敏感性和特异性较高。

Objective To investigate the diagnostic value of MRI in ovarian cystadenocarcinoma. Meth-ods A retrospective analysis of the records was done for 131 patients with ovarian cystic lesions（confirmed by gold standard of postoperative pathological examination results）cared at our hospital January 2010 ~January 2013,the participants（including 71 cases of benign cystic lesions,60 cases of ovarian cystadenocarcinoma）re-ceived MRI examination before operation and pathological examination,the sensitivity and specificity of MRI were observed and ovarian cystadenocarcinoma signs on MRI were analyzed. Results All the patients were diagnosed by MRI with accurate positioning,75 cases of them were located in adnexa uteri,54 cases in upper parts of the uterus,2 cases in front parts of the uterus;the accuracy of localization diagnosis was 100%,the di-ameter was 2.5~38.9 mm.MRI diagnosed 69 cases of ovarian cystic adenoma,62 cases of ovarian cyst adeno-carcinomas,39 cases of serous cystadenocarcinoma,23 cases of mucinous cystadenocarcinoma,compared with the pathological results（benign 71 cases,malignant 60 cases）,the diagnostic sensitivity was 88.33%（53/60）, the specificity was 92.96% （66/71 ）.Majority of patients with ovarian cystadenocarcinoma were typeII,ac-counting for 91.36%,patients with ovarian cystadenoma were mainly type I,accounting for 73.91%.The typ-ing of benign and malignant lesions showed statistical difference（P ＆lt;0.05）.MRI diagnosed 62 cases with ovar-ian cystadenocarcinoma were single in 13 cases,accounting for 20.97%,multiple in 49 cases,accounting for 79.03%.MRI had the performance of the pelvic signal,irregular shape,uneven cystic,solid and cystic,solid and cystic masses;T1 WI was equal or high and low mixed signal,T2WI presented with inhomogeneous high signal, 22 cases underwent enhanced scan showed no enhancement in cystic part,sac without enhancement,the solid part of moderate or marked enhancement.Cystic mass had irregularly thickened cystic wall,cystic TlWI showed low or high signal,high signal in T2WI.62 patients had ascites syndrome. Conclusion MRI can accurately obtain ovarian cystic lesions positioning,and can accurately display the mass shape,size and invasion range, with high sensitivity and specificity.