卵巢囊腺癌的MRI和CT诊断价值  

The diagnostic value of ovarian cystadenocarcinoma with MRI and CT

作　　者：吴春芳[1] 朱勇[1] 乌有弘[1] 蔡瑾[1] 罗行中[1] 

机构地区：[1]上海市徐汇区中心医院放射科,200031

出　　处：《上海医学影像》2009年第2期113-116,共4页Shanghai Medical Imaging

摘　　要：目的探讨MRI和CT对卵巢浆液性囊腺癌和黏液性囊腺癌的应用价值与选择。方法回顾性分析22例MRI诊断卵巢囊腺癌经手术和病理证实的资料,结合CT对照分析。结果MRI诊断14/22例为浆液性囊腺癌,8/22例为黏液性囊腺癌。病理13/14例为浆液性囊腺癌,1/14例为浆、黏液性囊腺瘤;5/8例为黏液性囊腺癌,3/8例为黏液性囊腺瘤。CT诊断10/20例为浆液性囊腺癌,10/20例为黏液性囊腺癌。病理9/10例为浆液性囊腺癌,1/10例为卵巢透明细胞癌;9/10例为黏液性囊腺癌,1/10例为浆液性囊腺癌伴出血。MRI及CT均可显示卵巢囊腺癌为囊实性病变,即敏感性差异不大,在特异性方面前者在平扫时显示更为优越,但在增强后的特异性则后者又超过前者,原因是MRI在增强扫描时采用T1WI,此时黏液改变亦为高信号与显示的对比剂相混杂导致增强失真的效果,而CT增强扫描则可明确显示局部的不规则囊壁以及壁结节的形成。因此CT所显示的特异性更强,亦即对诊断的正确性更高。结论浆液性囊腺癌MRI与CT应用价值相近,黏液性囊腺癌CT定性优于MRI。Objective To discuss the value of clinical application and choice with MILI/CT for diagnosing ovarian serous cystadenocarcinoma and ovarian mucinous cystadenocarcinoma. Methods To analyse 22 cases of ovarian through MRI confirmed by surgicopathology and compare with those of the relevant CT cystadenocarcinoma retrospectively. Results MRI revealed 14/22 cases of ovarian serous cystadenocarcinoma,8/22 cases of ovarian mucinous cystadenocarcinoma, and pathology confirmed 13/14 cases as the serous cystadenocarcinoma,1/14 case as the ovarian seromucinous cystadenoma,S/8 cases for mucinous cystadenocarcinoma. 3/8 cases for mucinous cystadenoma. CT showed 10/20 cases as the serous cystadenocarcinoma, 10/20 cases as the mucinous cystadenocarcinoma, and pathology proved 9/10 cases for serous cystadenocarcinoma, 1/10 case for ovarian clear cell carcinoma, 9/10 cases for mucinous cystadenocarcinoma, 1/10 case for serous cystadenocarcinoma complicated with bleeding. Furthermore, the characteristic or unique features contributed with MRI and CT were comprehended as follows. Both of MRI and CT can demonstrate ovarian cystadenocarcinoma as cystic and consistent mass that means no significant difference in sensitivities. As regards to specificities, plain MRI can unveil more clearly the mass ingredients than those through CT, outcoming with profitable benefit in specificity; but conversely enhanced CT can demonstrate the enhanced regional wall irregularities and nodules while MRI can＇ t do so clearly and precisely due to the presence of higher signal intensities caused by mucin on enhanced MRI. TIWI with intermingling of the paramagnetic substance （GD. DTPA）, leading to comparatively lower specificity. Conclusion MRI and CT are nearly equal in application of diagnosing ovarian serous cystadenocarcinoma. But CT is superior to MRI in diagnosing the qualification of ovarian mucinous cystadenocarcinoma.

关 键 词：卵巢 囊腺癌 磁共振成像 体层摄影术 X线计算机 

分 类 号：R739.41[医药卫生—肿瘤] R737.31[医药卫生—临床医学]