卵巢囊腺瘤CT和MRI诊断价值及影像特点分析

Diagnostic value and imaging characteristics of CT and MRI of ovarian cystadenoma

目的分析卵巢囊腺瘤电子计算机断层扫描(CT)及磁共振成像(MRI)影像特点。方法回顾性分析河北省衡水市人民医院2012年10月至2016年5月经手术病理证实的54例卵巢囊腺瘤患者的影像资料,围绕浆液性囊腺瘤、黏液性囊腺瘤、交界性囊腺瘤、囊腺癌患者平均年龄、病变大小及各自影像特征进行对比分析。结果 54例卵巢囊腺瘤患者病理结果为:浆液性囊腺瘤27例、黏液性囊腺瘤13例、交界性浆液性囊腺瘤2例,囊腺癌12例,CT诊断准确率为92.59%(50/54),MRI诊断准确率92.31%(12/13),二者诊断准确率比较差异无统计学意义(χ2=0.001,P>0.05)。浆液性囊腺瘤、黏液性囊腺瘤、囊腺癌3组不同性质卵巢肿瘤患者年龄、病变直径均有显著性差异(F值分别为4.418、3.976,均P<0.05),病灶部位无显著性差异(Fisher法,P=0.135),内部结构有显著性差异(Fisher法,P=0.000),浆液性囊腺瘤与粘液性囊腺瘤囊腔CT值有显著性差异(t=3.378,P<0.05)。结论在卵巢囊腺瘤诊断中CT和M RI均可获得理想的诊断结果。浆液性囊腺瘤以单房多见,囊壁可以钙化,壁结节少见,可双侧发病,粘液性囊腺瘤以多房为主,囊壁少有钙化,可有壁结节,囊腺癌体积略小,以囊实性病变为主,实性成分显著强化,对其分析有助于卵巢囊腺瘤的初步诊断及良恶性鉴别诊断。

Objective To analyze the imaging characteristics of CT and MRI of ovarian cystadenoma. Methods Imaging data of 54 patients confirmed with ovarian cystadenoma by operation and pathology in Henshui People＇s Hospital of Hebei Province from October 2012 to May2016 was analyzed retrospectively. Comparison was performed on average age,lesion size and imaging features among cases with serous cystadenoma,mucinous cystadenoma,borderline cystadenoma and cystadenocarcinoma. Results Pathological results of 54 patients with ovarian cystadenoma were as follows： 27 cases of serous cystadenoma,13 cases of mucinous cystadenoma,2 cases of borderline serous cystadenoma,and 12 cases of cystadenocarcinoma. Diagnostic accuracy of CT and MRI was 92. 59%（ 50/54） and 92. 31%（ 12/13）,respectively,and the difference between them was not statistically significant（ χ2= 0. 001,P 〈 0. 05）. Age and lesion diameter were significantly different among patients with serous cystadenoma,mucinous cystadenoma and cystadenocarcinoma（ F value was 4. 418 and3. 976,respectively,both P 〈 0. 05）. Lesion location was not significantly different（ Pfisher 0. 05）,but internal structure had significant difference（ Pfisher 0. 05）. CT imaging of cystic cavity had significant difference between serous cystadenoma and mucinous cystadenoma（t = 3. 378,P 〈 0. 05）. Conclusion CT and MRI can both obtain ideal diagnosis results in ovarian cystadenoma. Serous cystadenoma is more common with single cavity and cyst wall can be calcified,wall nodules are rare,and can be bilateral. Mucinous cystadenoma is mainly multilocular,and cyst wall has little calcification,probably with wall nodules. Size of cystadenocarcinoma is smaller and it is mainly cystic solid lesion,and its solid components are significantly enhanced. The analysis is helpful for initial diagnosis of ovarian cystadenoma and differential diagnosis of benign and malignant lesions.