基于3.0T磁共振对卵泡膜纤维瘤与卵巢颗粒细胞瘤的鉴别诊断研究

Value of 3.0 T MR in differential diagnosis of ovarian thecoma-fibroma and OGCT

目的:探讨3.0T磁共振成像(MRI)的多参数成像对卵泡膜纤维瘤与卵巢颗粒细胞瘤(OGCT)的鉴别诊断价值。方法:选取医院经手术病理证实的22例卵泡膜纤维瘤和11例OGCT患者资料,分别纳入卵泡膜纤维瘤组(22例)和OGCT组(11例),分析两组患者的临床月经情况、肿瘤大小、子宫内膜厚度、MRI信号、增强特点及肿瘤成分特征,寻找能有效鉴别两种疾病的临床影像学特征。结果:两组资料在表观弥散系数(ADC)、肿瘤出血情况、T_(2)加权成像(T_(2)WI)及扩散加权成像(DWI)信号特点、三期增强扫描强化特点及肿瘤囊变形式的比较,差异均有统计学意义(Fisher精确检验,P<0.05)。两组患者疾病间临床月经情况、子宫内膜厚度、肿瘤大小及肿瘤的囊变分级之间的差异均无统计学意义。结论:3.0TMRI可以提供较多的反映卵泡膜纤维瘤与卵巢颗粒细胞瘤组织学特征的影像学信息,其中DWI及T_(2)WI信号特点、ADC值、肿瘤强化程度、肿瘤出血及肿瘤囊变形式在术前两种疾病鉴别诊断中具有重要意义。

Objective:To explore the value of differential diagnosis of 3.0 T magnetic resonance imaging(MRI)for ovarian thecoma-fibroma and ovarian granulosa cell tumor(OGCT).Methods:The data of 22 patients with ovarian thecoma-fibroma and 11 patients with OGCT who were confirmed by surgery and pathology were collected,and they were respectively divided into ovarian thecoma-fibroma group(22 cases)and OGCT group(11cases).The menstrual history,tumorous size,endometrial thickness,MRI signal,enhancement characteristics and tumor component characteristics of the two groups were retrospectively analyzed.And then,the clinical and radiographic characteristics that can effectively identify the two kinds of diseases were explored and analyzed.Results:There were significant differences in apparent diffusion coefficient(ADC),tumor hemorrhage,signal characteristics of T_(2) weighted imaging(T_(2)WI)and diffusion weighted imaging(DWI),enhancement characteristics of enhanced scanning at third-stage and the form of cystic change of tumor between the two groups(Fisher exact test,P<0.05).There were no significant differences in clinical menstrual history,endometrial thickness,tumor size and cystic grade of tumor between the two groups(P>0.05).Conclusion:3.0 T MRI can provide more imaging information that reflect the histological characteristics of ovarian thecoma-fibroma and OGCT.The signal characteristics of DWI and T_(2)WI,ADC value,tumor enhancement degree,tumor hemorrhage and the form of cystic change of tumor have important significance in preoperative differential diagnosis of the two diseases.