卵巢交界性浆液性与黏液性肿瘤的CT鉴别诊断价值

CT Differential Diagnosis of Borderline Serous and Mucinous Tumors of Ovary

目的探讨CT对于卵巢交界性浆液性肿瘤（S-BOT）与交界性黏液性肿瘤（M-BOT）的鉴别诊断价值。方法回顾性分析经手术病理证实的18例S-BOT和21例M-BOT患者的CT资料,观察肿瘤部位、大小、形态学征象、密度以及增强率,结果与病理对照。S-BOT与M-BOT大小、密度的比较采用两独立样本t检验,形态学征象的比较采用χ^2检验。结果 M-BOT最大径明显大于S-BOT（18.3 cm vs 11.7 cm）。M-BOT内软组织平扫密度高于S-BOT;在增强后各期中,S-BOT强化率均高于M-BOT,差异有统计学意义。S-BOT与M-BOT均表现出延迟强化的特点。S-BOT多以单房囊样形式出现,M-BOT则多呈多房囊样表现;并且S-BOT的囊液密度较M-BOT更均质,差异有统计学意义。在囊实性肿块中,S-BOT的软组织形态多表现为肿块内部软组织呈地图样分布,无定型;M-BOT以囊壁及间隔增厚多见,差异有统计学意义。囊液均质性对S-BOT诊断的灵敏度和特异度分别为78.9%和71.4%。多房囊样表现、囊壁间隔增厚对M-BOT诊断的灵敏度和特异度分别为90.5%和57.9%、38.1%和94.7%。S-BOT较M-BOT易出现种植转移。结论 S-BOT与M-BOT在CT征象上具有一定的差异,CT有助于两者的鉴别诊断。

Objective To investigate CT features for differentiating serous borderline ovarian tumor（S-BOT） form mucinous borderline ovarian tumor（M-BOT）.Methods The CT data of 18 patients with S-BOT and 21 patients with M-BOT confirmed by surgery and pathology were retrospectively analyzed.The tumor location,size,morphology,density,and enhancement rate were observed.The results were compared with pathology.S-BOT and M-BOT size and density comparison using two independent samples t test,morphological signs using the χ^2 test.Results The maximum diameter of M-BOT was significantly larger than that of S-BOT（18.3 vs 11.7 cm）.The normal density of soft tissue in M-BOT was higher than that of S-BOT.In each phase of enhancement,the enhancement rate of S-BOT was higher than that of M-BOT,and the difference was statistically significant.Both S-BOT and M-BOT showed delayed enhancement.S-BOT mostly appeared as a single chamber cyst,M-BOT showed mostly multi-house sac-like performance;and S-BOT cystic fluid density was more homogenous than M-BOT,and the difference was statistically significant.In cystic masses,the soft tissue morphology of S-BOT mostly showed the distribution of the soft tissue inside the mass in a map-like pattern,and there was no stereotype;the thickening of the M-BOT was more common in the wall and septum,and the difference was statistically significant.The sensitivity and specificity of cyst fluid homogeneity in the diagnosis of S-BOT were 78.9% and 71.4%,respectively.The sensitivity and specificity of multi-sac sac-like performance and septal thickening in the diagnosis of M-BOT were 90.5% and57.9%,38.1%,and 94.7%,respectively.Compared with M-BOT,S-BOT tends to have planting metastasis.Conclusion S-BOT and M-BOT have certain differences in CT signs.CT is helpful for the differential diagnosis of the two.