磁共振弥散加权成像联合增强扫描诊断卵巢常见囊性肿瘤  

Combined DWI and enhanced MRI in diagnosis of ovarian cystic tumors

作　　者：姚新宇[1] 许卫[1] 万璐[1] 陈楠[1] 李坤成[1] 

机构地区：[1]首都医科大学宣武医院放射科,北京100053

出　　处：《中国医学影像技术》2016年第1期99-103,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨MR DWI联合MR增强扫描对卵巢常见囊性肿瘤的诊断及鉴别诊断价值。方法对80例经手术及病理证实的卵巢囊性肿瘤(其中卵巢囊腺癌35例,交界性卵巢囊腺瘤21例,卵巢囊腺瘤24例)患者行术前MR检查,分析肿瘤的DWI表现及强化特征,并进行统计学分析。结果 3种卵巢囊性肿瘤的侧别及大小差异均无统计学意义(P均>0.05)。卵巢囊腺癌的ADC值[(930.77±291.77)×10^(-6) mm^2/s]明显低于交界性卵巢囊腺瘤[(1 326.18±294.41)×10^(-6) mm^2/s,P<0.05]。卵巢囊腺瘤的ADC值[(1 932.64±295.35)×10^(-6) mm^2/s]明显高于其他两类型肿瘤(P<0.05)。增强扫描后,卵巢囊腺癌、交界性卵巢囊腺瘤及卵巢囊腺瘤明显强化率分别为91.43%(32/35)、57.14%(12/21)和12.50%(3/24)。将交界性肿瘤归入恶性肿瘤,ADC值对恶性病变诊断的敏感度和特异度分别为92.7%和91.7%,增强扫描对恶性病变诊断的敏感度、特异度分别为80.0%、87.5%,而两者联合的敏感度、特异度分别为96.4%、91.7%。结论MR DWI联合MR增强扫描可反映卵巢囊性肿瘤的病理特点,对良性与非良性肿瘤的诊断及鉴别诊断具有重要意义。Objective To evaluate the value of DWI combining with enhanced MRI for the diagnosis and differential diagnosis ovarian cystic tumors.Methods Eighty patients with ovarian cystic tumors（35were cystadenocarcinoma,21 were borderline and 24 were benign cystadenomas）confirmed by surgery and pathology were enrolled.All patients were examined with enhanced MRI and DWI before operation.The features of the tumor on DWI and enhanced MRI were statistically analyzed.Results There was no difference on the side and size of ovarian cystic tumors on conventional MRI.The ADC of ovarian cystadenocarcinoma was（[930.77±291.77]×10^-6 mm^2/swere lower than that of junctional tumors（[1 326.18±294.41]×10^-6 mm^2/s;the ADC of cystadenomas（[1 932.64±295.35]×10^-6 mm^2/swere obviously higher than those of the others.On enhanced MRI,the obvious enhancement rate of cystadenocarcinoma,junctional and benign cystadenomas were 91.43%（32/35）,57.14%（12/21）and 12.50%（3/24）,respectively.Junctional and cystadenocarcinoma was classified into malignant tumors,the sensitivity and specificity for ADC in evaluation of malignant ovarian lesions were92.7% and 91.7%,respectively,which for contrast-enhanced MRI were 80.0% and 87.5%,and for combined with contrast-enhanced MRI and DWI were 96.4%and 91.7%,respectively.Conclusion Combined DWI and enhanced MRI can display the pathological features of ovarian cystic tumors,which is useful for differentiating benign and malignant ovarian tumor.

关 键 词：卵巢囊性肿瘤 扩散磁共振成像 对比剂 

分 类 号：R737.3[医药卫生—肿瘤] R445.2[医药卫生—临床医学]