卵巢透明细胞癌的CT、MRI表现及分期评估

CT and MRI performance and stage evaluation of ovarian clear cell carcinoma

目的:分析卵巢透明细胞癌(OCCC)的CT、MRI特征,提高术前及早期诊断水平。方法:回顾性分析经病理证实的OCCC 30例患者(31个病灶)的影像资料,总结OCCC的特征:位置、形态、边界、分隔、大小、囊实性成分、强化方式及伴随症状;评估以上特征在早期(Ⅰ期)及进展期(>Ⅰ期)间是否有差异。结果:30例(31个病灶)的主要特征:单侧(29/30),类圆形(23/31),界清(26/31),单房(25/31),囊实性(29/31),肿瘤平均直径(11.1±4.9)cm。囊性部分平均CT值(20.8±8.4)HU,T1WI以低信号为主。实性部分DWI呈高信号,平均ADC值(1.2±0.2)×10^(-3) mm^(2)/s。增强扫描20个病灶明显持续强化。早期与进展期在腹水、静脉栓塞并发症方面差异均有统计学意义(P=0.015,0.027)。结论:OCCC有一定影像特征,当伴腹水、静脉栓塞时,更倾向进展期可能。

Objective:To explore CT and MRI features of ovarian clear cell carcinoma(OCCC)to improve preoperative and early stage diagnosis of this disease.Methods:The imaging findings of 30 patients(31 lesions)with OCCC proven by pathology were retrospectively analyzed,including the location,shape,size,margin,cystic and solid component feature,mass enhancement characteristics,and secondary manifestations.Diverse imaging features were assessed between early(Ⅰstage)and advanced(>Ⅰstage)OCCC.Results:Most lesions were unilateral(29/30),ovoid(23/31),well-defined(26/31),and unilocular(25/31),cystic appearance with lumen protruding mass(29/31).The mean diameter of the tumors was(11.1±4.9)cm.The mean CT value of cystic was(20.8±8.4)HU and cystic portion mainly showed hypointense on T1WI.The solid portion showed hyperintense on DWI,and ADC value of solid portion was(1.2±0.2)×10^(-3) mm^(2)/s.There was statistically significant difference between early and advanced stage OCCC in ascites(P=0.015),venous thromboembolism(P=0.027).Conclusion:Some typical radiographic presentations appear in OCCC.Tumor tends to advanced stage with ascites and venous thromboembolism.