MRI鉴别卵巢良性与交界性黏液性囊腺瘤的价值  

MRI features in differentiation borderline from benign mucinous ovarian cystadenoma

作　　者：赵书会[1] 强金伟[1] 张国福[2] 邱海英[1] 王雪珍[2] 王丽[3] 

机构地区：[1]复旦大学附属金山医院放射科,上海200540 [2]复旦大学附属妇产科医院放射科 [3]复旦大学附属妇产科医院病理科

出　　处：《中华放射学杂志》2012年第4期327-331,共5页Chinese Journal of Radiology

基　　金：基金项目：上海市卫生局基金资助项目（2008-196）

摘　　要：目的探讨MRI对良性卵巢黏液性囊腺瘤（MC）与交界性卵巢黏液性囊腺瘤（BMC）的鉴别诊断价值。方法回顾性分析经手术病理证实的23例良性MC和19例BMC患者（良性肿瘤23个、交界性肿瘤20个）的术前MRI表现，观察肿瘤的部位、形态、大小、分房、囊液信号、囊壁及分隔和肿瘤赘生物等情况，结果与病理对照。采用χ2检验比较MC与BMC肿瘤分房、囊液信号、囊壁或分隔增厚及肿瘤赘生物的差异。结果T1WI单一低信号和T2WI单一高信号为良性MC的主要信号类型（18／23和17／23），出现率较BMC高（5／20和8／20），差异有统计学意义（χ2值分别为12．1979和5．0553，P值均〈0．05）。蜂窝状子房、T1WI含高信号囊液、T2WI含低信号囊液、囊壁或分隔不规则增厚（≥5mm）及结节或乳头状突起（≥5mm）5个征象在BMC（10／20、9／20、8／20、10／20和14／20）均较良性多见（4／23、3／23、1／23、1／23和1／23）（χ2值分别为5．1804、5．4300、8．2163、11．7113和20．2990，P值均〈0．05），对BMC的诊断敏感度和特异度分别为50．0％和82．6％、45．0％和87．0％、40．0％和95．7％、50．0％和95．7％、70．0％和95．7％。出现T2WI低信号的蜂窝状子房、囊壁或分隔不规则增厚（≥5mm）、结节或乳头状突起（≥5mm）3个征象之一时，MRI诊断BMC的敏感度、特异度和准确度分别为90．0％、91．3％和90．7％。结论MRI可很好地显示卵巢BMC的病理特征，可靠地鉴别良性与BMC，有助于手术方案的制订。Objective To investigate MRI features for differentiating borderline from benign mucinous cystadenoma （MC） of the ovary. Methods Twenty three patients with 23 benign MCs and 19 patients with 20 borderline mucinous cystadenomas （ BMC ） proven by surgery and pathology underwent MRI, with 23 benign MCs and 20 BMC. MRI features of tumor were evaluated and compared between two groups including location, shape, size, loculation, signal intensity of the fluid, thickness of septa and wall, and vegetations. The findings were correlated with those of pathology. The loculation, the signal intensity of the intracystie content, the thickness of the septation and the wall, and the vegetations between the benign MCs and the BMCs were compared using the Chi-square test. Results Homogenous low signal on T1WI and homogenous high signal on T2 WI were the main signal patterns of benign MC seen more commonly in benign MC （18/23 and 17/23, respectively） than in BMC （5/20 and 8/20, respectively） （χ2 = 12. 1979, 5. 0553 ;P 〈 0. 05 ）. The honeycomb loculi, high signal on T1 W1, low signal on T2WI, thickened septa or wall （ ≥5 mm） , and vegetations （ i〉5 ram） were significantly more common in BMC（ 10/20, 9/20, 8/20, 10/20 and 14/20, respectively）than in benign MC （4/23, 3/23, 1/23, 1/23 and 1/23, respectively） （χ2 =5. 1804, 5.4300, 8. 2163,11. 7113 and 20. 2990,P 〈0. 05 ）, with the sensitivity and specificity for characterizing BMC of 50. 0% and 82. 6%, 45. 0% and 87. 0%, 40. 0% and 95.7%, 50. 0% and 95.7% , and 70. 0% and 95.7%, respectively. When one of honeycomb loculi with low signal on T2WI,thickened septa or wall （ ≥5 mm）, and vegetations （≥5 mm） were found, the sensitivity, specificity and accuracy for characterizing BMC were 90. 0%, 91.3% and 90. 7% respectively. Conclusion MRI is accurate for demonstrating morphological features of ovarian MC which well correlated to pathological characteristics, and for differentiating BMC from benign MC, thus helpful for making surge

关 键 词：卵巢肿瘤 磁共振成像 对比研究 

分 类 号：R737.31[医药卫生—肿瘤]