女性卵巢粘液性囊腺瘤MSCT表现及与粘液性囊腺癌的鉴别诊断

MSCT Manifestations of Ovarian Mucinous Cystadenoma and Its Differential Diagnosis from Mucinous Cystadenocarcinoma

目的分析女性卵巢粘液性嚢腺瘤MSCT表现及与粘液性囊腺癌的鉴别诊断。方法收集本院2017年3月至2019年5月经手术病理检查确诊的卵巢粘液性嚢腺瘤、粘液性囊腺癌患者的临床资料。所有患者在手术前均进行MSCT检查,对粘液性嚢腺瘤、粘液性囊腺癌患所得MSCT图像进行分析,总结两者CT征象。结果卵巢粘液性嚢腺瘤MSCT表现:肿瘤表现为多房,囊液黏稠,CT值常高于水,但低于软组织,约为12~26HU;可见肿瘤囊壁较薄,不均匀,边界清晰,囊内可见多个细条样间隔形成多个小囊;肿瘤较大直径>10cm,少数患者可见软组织有乳头状突起;增强扫描后肿瘤分隔表现为中度强化。粘液性囊腺癌MSCT表现:卵巢粘液性嚢腺癌肿瘤多为实性,肿瘤边缘可见凸起,形态不规整,瘤体常为多房形;肿瘤密度不均匀,CT值常在35HU以上;增强扫描可见实性部分明显强化,部分患者可合并腹水或出现淋巴结转移、肝脏转移等。结论卵巢粘液性囊腺瘤与粘液性囊腺癌MSCT征象存在一定差异,通过分析MSCT征象可进行鉴别诊断。

Objective To analyze the MSCT manifestations of ovarian mucinous cystadenoma and its differential diagnosis from mucinous cystadenocarcinoma.Methods The clinical data of patients with ovarian mucinous cystadenoma or mucinous cystadenocarcinoma confirmed by surgical pathology from March 2017 to May 2019 were collected.All patients were examined with MSCT before surgery,and the MSCT images of patients were analyzed,and the CT signs of the them were summarized.Results MSCT manifestations of mucinous cystadenoma:The tumor was multilocular,the cyst fluid was thick,and the CT value was often higher than that of water,but lower than that of soft tissue,about 12~26 HU.It can be seen that the cyst wall of the tumor was thin,uneven,and the boundary was clear,and there were multiple separation like thin strips in the capsule to form multiple small capsules.The larger diameter of the tumor was>10cm.Papillary protrusions were seen in soft tissues in a few patients.Tumor separation showed moderate enhancement after enhanced scanning.MSCT manifestation of mucinous cystadenocarcinoma:The tumors of ovarian mucinous cystadenocarcinoma were mostly solid,the protrusions were seen in the edges.The shape was irregular,and the tumor was usually multilocular.The density of the tumor was uneven,and the CT value was usually above 35 HU.The enhancement scan showed that the solid part was significantly enhanced,and some patients may have ascites or lymph node metastasis and liver metastasis.Conclusion There are some differences in the MSCT signs between ovarian mucinous cystadenoma and mucinous cystadenocarcinoma.Differential diagnosis can be made by analyzing MSCT signs.