卵巢癌腹膜转移的MRI与手术对照分析  

Comparative Study of Surgical Pathology and MRI in Ovarian Cancer Peritoneal Carcinomatosis

作　　者：王志龙[1] 肖学红[1] 黄晓星[1] 汪泽燕[1] 

机构地区：[1]中山市人民医院(中山大学附属中山医院)MR室,广东省中山市528403

出　　处：《现代医用影像学》2015年第2期157-160,共4页Modern Medical Imageology

摘　　要：目的:探讨MRI在卵巢癌腹膜转移(peritoneal carcinomatosis,PC)的应用价值。材料与方法:由2名高年资影像学医师对20例经手术病理确诊卵巢癌PC患者的下腹部MRI资料进行分析,MRI检查包括T_1WI、T_2WI、DWIBS和增强3DTHRIVE序列,主要观察卵巢单侧或双侧受累,并依次对子宫、直肠乙状结肠、膀胱、盆壁、子宫直肠陷窝、下腹部大网膜进行观察,记录是否有卵巢肿瘤及其PC的侵犯,并与手术所见、病理进行对照。结果:在卵巢癌单侧或双侧受累(P=1.00)以及肿瘤侵犯子宫(P=0.50)、直肠乙状结肠(P=1.00)、膀胱(P=0.25)、盆壁(P=0.18)子宫直肠陷窝(P=1.00)、下腹部大网膜(P=1.00)等方面,MRI与手术所见无显著性差异。将MRI发现与手术所见、病理作对照,MRI检出肿瘤侵犯子宫、直肠乙状结肠、子宫直肠陷窝、下腹部大网膜、膀胱、盆壁的敏感性与特异性分别为85.7%/75%、100%/100%、100%/100%、90%/:100%、58.8%/0%、45.5%/22.2%。结论:MRI能检出并准确地评价卵巢癌腹膜转移在盆腔的侵犯范围,可为临床制定治疗方案提供可靠的影像学依据,但在评价膀胱、盆壁侵犯方面存在一定的局限性。Purpose： To discuss the application value of MRI in diagnosing ovarian cancer peritoneal carcinomatosis （PC） with surgical pathology. Materials and Methods： Pelvic MRI findings were retrospective reviewed in 20 patients with ovarian cancer peritoneal carcinomatosis confirmed by operation and pathology. MRI included T1-weighted, T2-weighted, DWIBS, and gadolinium-enhanced 3D THRIVE sequences. MRI findings of unibilateral or bilateral ovarian tumors involve- ment, and the ivasion of uterus, proctosigmoid, bladder, pelvic wall, reetouterine pouch and greater omentum in lower abdomen by ovarian cancer peritoneal carcinomatosis were analyzed and recorded by two experienced radiologists, decisions were made by consensus when there was a divergence of opinion, and then compared with the operation results. Results： There was no difference in ovarian unibilateral or bilateral involvement （P = 1.00 ） and the invasion of uterus （P = 0. 50 ） , proetosigmoid （P = 1.00）, bladder （P = 0. 25 ）, pelvic wall （P = 0. 18 ）, treetouterine pouch （P = 1.00 ） and greater omentum in lower abdo- men （P = 1.00） between MRI and operation resuhs. Furthermore, we compared the MRI findings with the laparotomy findings from operative records, the sensitivity and specificity of MRI to detected the invasion of uterus, proctosigmoid, reetouterine pouch, greater omentum in lower abdomen, pelvic lymph node, bladder, pelvic wall were 85.7 and 75% , 100% and 100% , 100% and 100%, 90% and 100%, 58.8% and 0%, 45.5% and 22. 2%. Conclusions： MRI can detect and precisely delineate the extent of ovarian cancer peritoneal careinomatosis in lower abdomen, and it can provide reliable imaging informa- tion for treatment planning, but it also has certain limitations in evaluate the tumor invasion of bladder and pelvic wall.

关 键 词：卵巢癌 腹膜转移 磁共振成像 手术 

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