卵巢内膜样腺癌的MRI表现  

MRI findings of ovarian endometroid adenocarcinoma

作　　者：李海明[1,2] 强金伟[1] 赵书会[3] 马凤华[1] 夏淦林[2] 

机构地区：[1]复旦大学附属金山医院影像科,上海201508 [2]南通市肿瘤医院放射科,江苏226361 [3]上海交通大学附属新华医院放射科,上海200092

出　　处：《放射学实践》2015年第5期582-586,共5页Radiologic Practice

基　　金：国家自然科学基金(81471628);上海市医学重点建设专科(ZK2012A16);上海市科委医学引导项目(124119a3300)

摘　　要：目的：探讨卵巢内膜样腺癌（OEC）的MRI表现,提高对该病的认识。方法：回顾性分析经手术和病理证实的20例OEC的MRI表现,观察肿瘤的部位、形态、大小、肿块质地、壁结节、信号强度、强化程度、腹膜种植灶、腹水、同时伴发子宫内膜癌的双原发癌（DPC）、子宫内膜息肉、子宫内膜异位症及临床分期等情况。结果：20例OEC共22个病灶,单侧发病18例（90%）,双侧2例（10%）,DPC 10例（50%）。13个（59%）病灶呈卵圆形,最大径约（11.2±5.1）cm（3.7～22.5cm）。病灶呈囊性为主伴壁结节15个（68%）,囊实性病灶5个（23%）,实性病灶2个（9%）。囊液T1WI呈均匀等或高信号者17例（85%）,T2WI呈均匀高信号者15例（75%）,DWI呈低信号者10例（63%,10/16）。实性成分T1WI均呈等信号,19个（86%,19/22）病灶T2WI呈不均匀高信号,14个（82%,14/17）病灶DWI呈高信号。出现卵圆形病灶、囊性为主伴壁结节、囊液T1WI呈均匀等或高信号时,诊断OEC的准确率分别为59%、68%和85%,联合上述3种征象诊断OEC的准确率为91%。结论：OEC的MRI表现有一定特征性,结合DWI有助于OEC的诊断。Objective：To investigate the MRI findings of ovarian endometrioid adenocarcinoma （OEC） and to improve the understanding of OEC. Methods：Twenty patients with OEC proven by surgery and pathology underwent MRI. MRI features of the tumors including location, morphology, size, characteristics of mass, mural nodule, signal intensity, enhancement,peritoneal implant,ascites, double primary carcinoma （DPC, which is primary OEC accompanied synchronously with endometrial carcinoma）, endometrial polyps, endometriosis, and clinical staging were evaluated. Results： Of the 20 patients, 22 masses were assessed,with unilateral ovarian masses in 18 patients （90%） and bilateral masses in the remaining 2 （10 % ）. Ten （50% ） patients had accompanied endometrial carcinoma （DPC）. The masses usually appeared as oval in shape in 13 masses （59%） with the maximum diameter as （11.1±5.2）cm （ranging from 3.7cm to 22.5cm）. Fifteen （68~） mas- ses were mainly cystic with mural nodules, 5 （23 %） were mixed cystic-solid and 2 （9%） were solid. The cystic component showed homogeneous iso-/hyperintensity （17 patients 85 % ） on T1 WI, homogeneous hyperintensity on T2 WI （15 patients, 75%） and hypointensity on DWI （10/16,63%）. The solid components of tumors showed isointensity （100%） on T1WI, heterogenous hyperintensity on T2 WI （19/22,86%） and hyperintensity on DWI （14/17,82%）. When the appearances of mass was oval shape, mainly cystic with mural nodules, and the signal intensity of cystic component with homogeneous iso-/ hyperintensity on T1 WI, the accuracy for diagnosing OEC was 59%, 68 % and 85 %, respectively. When the above-mentioned three features were considerd in combination, the accuracy for the diagnosis was 91%. Conclusion：On MRI, OEC had certain characteristic features,which are helpful for the diagnosis when combination with DWI was performed.

关 键 词：卵巢 内膜样腺癌 磁共振成像 扩散加权成像 

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