3．0TMRI对卵巢良恶性肿瘤定性的诊断价值  

The value of 3.0T MRI for the diagnosis of the ovarian tumor

作　　者：袁晓春[1] 王夕富[1] 姚戈虹[1] 郑林丰[1] 胡运胜[1] 张贵祥[1] 

机构地区：[1]上海交通大学附属第一人民医院放射科,上海200080

出　　处：《实用放射学杂志》2011年第11期1695-1698,1712,共5页Journal of Practical Radiology

摘　　要：目的探讨3．0TMR常规方法结合LAVA动态增强扫描及DWI技术对卵巢肿瘤定性的诊断价值。方法经手术病理证实的35例卵巢肿瘤，采用3．0TMRI系统进行SET1WI、FSET2WI、脂肪抑制T2WI；LAVA动态增强扫描，DWI（b=0，600s／mm^2）成像。分析卵巢肿瘤的形态，大小，有无囊性或实性成分。观察卵巢肿瘤在各序列上的信号特点，LAVA动态增强实性成分的强化曲线，DWI序列ROI选在肿块实性成分上，并计算ADC值。结果35例患者中单侧病灶为25例，双侧病灶为10例。其中卵巢良性肿瘤18例22个，恶性或交界性肿瘤共17例23个。术前诊断卵巢囊性病灶13个，囊实性病灶27个，实性病灶5个。LAVA动态增强扫描，32个含实性成分的病灶在动脉早期强化19个，动脉晚期强化9个，实质期强化1个，延迟期强化1个．不强化病灶2个。DWI序列13例呈高信号，20例为高低混杂信号，2例为低信号。32个含实性成分的卵巢肿瘤ADC值测量硅示，良性肿瘤组ADC平均值为（1．17±0．34）×10^-3mm^2/s，恶性肿瘤为（1．24±0．21）×10^-3mm^2／s，良恶性病变组ADC值无统计学意义（P〉0．05）。与手术、病理结果比较，MR对卵巢肿瘤定性的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为86．7％（39／45）、91．3％（21／23）、81．8％（18／22）、84．0％（21／25）、90．0％（18／20）。结论3．0TMR常规序列结合LAVA动态增强及对卵巢肿瘤的诊断与鉴别诊断具有重要价值，可为临床选择治疗方案提供可靠的信息，而DWI技术起辅助诊断作用。Objective To investigate the value of 3.0T MRI with routine sequences, LAVA and DWI in diagnosis of the ovarian tumor. Methods 35 patients with ovarian tumor confirmed by surgery and pathology were retrospectively analysed. All cases underwent MR imaging including axial FSE T1WI and FSE T2WI, sagittal T2WI with fat saturation, LAVA and DWI sequence （b=0, 600 s/mm^2 ） at 3.0T GE MR scanner. The morphologic features including lesion size, cystic septa and/or solid part,the signal featureswere observed on every MR sequences. Signal and enhancement patterns of the solid part were evaluated at LAVA sequence using dynamic curves. At DWI sequence, the ROI was placed on the solid part and ADC values were measured. Results 35 patients with 45 lesions included unilateral tumors in 25 patients and bilateral minors in 10 patients. There were 22 benign lesions in 18 patients and 23 malignantor borderline lesions in 17 patients . 13 pure cystic lesions , 27 solid masses with cystic proportions and 5 pure solid masses were diag nosed preoperatively. Solid or partial solid tumors enhanced in 19 cases in early arterial phase, 9 cases in late arterial phase and 1 case in parenchyma phase, 1 case in delay phase, 2 cases without enhancement. The lesions were high signal intensity in 13, mixed signal intensity in 20, and low signal intensity in 2 at DWI sequence. The average ADC value of benign tumors was （1.17±0.34） × 10^-3mm^2/s, and malignant tumors was（1. 24 ±0. 21） × 10^-3 mm^2/s . These was no statistical significance between these two groups（ P〉0.05）. By incorporating morphologie and signal features, MRI successfully diagnosed ovarian tumors with an accuracy of 86.7%（39/45）,sensitivity of 91.3%（21/23） ,specificity of 81.8% （18/22） ,positive predictive value of 84.0% （21/25）and negative predictive value of 90.0 % （18/20）respectively. Conclusion MRI with LAVA dynamic enhancement can play an important role in the differentiation of benign and malignant ovarian tumors, also can provide val

关 键 词：卵巢 肿瘤 磁共振成像 

分 类 号：R737.31[医药卫生—肿瘤] R445.2[医药卫生—临床医学]