Krukenberg瘤的磁共振诊断

MRI manifestations of Krukenberg tumors

目的:比较Krukenberg瘤与原发性卵巢肿瘤的MRI特点,探讨Krukenberg瘤的影像学特征。方法:回顾性分析经手术病理证实的24例Krukenberg瘤和60例原发性卵巢肿瘤的MRI表现。依据MRI信号将肿瘤分为3型:实性为主型、囊实性及囊性为主型。结果:24个Krukenberg瘤患者共发现39个病灶,发生于双侧卵巢15例、单侧9例。39个病灶中,实性为主型20个、囊实性11个、囊性为主型8个;增强后病灶实性成分和(或)囊壁明显强化。60例卵巢原发肿瘤患者共发现87个病灶,发生于双侧卵巢27例、单侧33例。87个病灶中,16个实性为主,19个囊实性,52个囊性为主。19个囊实性肿块增强后有4个(4/19,21.0%)囊肿壁明显强化。结论:当双侧卵巢出现实性或囊实性肿块,尤其肿块中囊肿壁出现明显强化时,应考虑Krukenberg瘤的可能。

Objective: To evaluate the MRI manifestations of Krukenberg tumors and to compare them with those of primary ovarian tumors. Methods: This study included 24 patients with Krukenberg tumors and 60 patients with various primary ovarian tumors. MRI studies of the tumors were categorized into three subgroups: a predominantly solid mass, a solid mass with intratumoral cysts, and a predominantly cystic mass. Results: Among 39 Krukenberg tumors(bilateral in 15 patients), 11 were solid masses with intratumoral cysts, and the solid part and(or) the cyst wall showed strong contrast enhancement on MRI. Twenty Krukenberg tumors were predominantly solid masses, and 8 were predominantly cystic masses. Among 87 primary ovarian tumors(bilateral in 27 patients), 19 were solid masses with intratumoral cysts, 16 were predominantly solid masses, and 52 were predominantly cystic masses. Of the 19 primary ovarian tumors with solid mass with intratumoral cysts, 4 tumors showed strong contrast enhancement of the cyst wall. Conclusion: Krukenberg tumor should be suspected when one sees bilateral solid ovarian tumor containing well-demarcated intratumoral cystic lesions, especially if the cyst walls demonstrate strong contrast enhancement.