CT及MRI在卵巢透明细胞癌术前评价中的对比应用

The application of CT and MRI in the preoperative evaluation of ovarian clear cell carcinoma

目的对比CT及MRI检查在卵巢透明细胞癌（CCC）术前评价中的应用价值。方法收集我院2010年1月～2014年12月经手术病理证实的卵巢透明细胞癌患者77例，平均年龄51．17岁。其中，65例患者行CT检查，58例同时行增强cT检查；12例患者行MRI检查，11例同时行增强MRI检查。分析患者的临床资料及影像资料，包括肿瘤大小、形态及CT、MRI表现。结果77例卵巢透明细胞癌患者，共81个病灶。CT和MRI对CCC术前FIGO分期诊断的准确率范嗣分别为81．54％～95．38％、75％～95．67％。CT及MRI对CCC淋巴结转移诊断的准确率分别为90．77％、84．62％；对CCC腹膜转移诊断的准确率分别为83．33％、91．67％；两者对CCC腹膜及淋巴结转移诊断准确率的卡方检验无统计学差异。卵巢透明细胞癌病灶边界清楚与否与肿瘤的淋巴结转移、腹膜转移相关，相关系数分别为，-0．299、-0．314，P〈0．05。结论CT及MRI均能很好地显示CCC病灶，对CCC术前淋巴结及腹膜转移的诊断具有较高的准确度，在CCC术前评价中具有重要应用价值。

Objective To investigate preoperative CT and MRI features of ovarian clear cell carcinoma. Methods 77 patients with pathologically confirmed ovarian clear cell carcinoma, with an average age of 51.17 in our hospital from January 2010 to December 2014, were collected in the study, of whom 65 underwent routine CT examination, 58 underwent contrast-enhanced CT examination, 12 underwent MRI examination and 11 underwent contrast-enhanced MRI examination. The clinical data and image data, including tumor size, shape, CT and MRI manifestation, were analyzed. Results A total of 81 lesions were collected. CT and MRI diagnostic accuracy range on each preoperative FIGO stage of CCC was 81.54% - 95.38% , 75%- 95.67% respectively. The diagnostic accuracy of CT and MRI was 90.77%, 84.62% respectively on lymph node metastasis and 83.33% , 91. 67% respectively on peritoneal metastasis. The Chi-square analysis of CT and MRI diagnostic accuracy on lymph node metastasis and peritoneal metastasis showed no statistical difference. Whether the ovarian clear cell carcinoma was well demarcated or not was associated with lymph node metastasis, peritoneal metastasis and ascites, with the correlation coefficients of -0. 299, - 0. 314, -0. 788 respectively and P 〈 0.05 for each. Conclusion MRI and CT can provide much valuable information of CCC and have high diagnostic accuracy on lymph node metastasis and peritoneal metastasis. Consequently, CT and MRI are of great value in the preoperative evaluation of CCC.