不典型原发性输卵管癌与卵巢囊腺癌的CT特征  

CT Features of Atypical Primary Carcinoma of the Fallopian Tube and Ovarian Cystadenocarcinoma

作　　者：李洁[1] 吴晶涛[1] 陈文新[1] 

机构地区：[1]江苏省苏北人民医院影像科,江苏扬州225001

出　　处：《中国医学影像学杂志》2015年第11期854-857,共4页Chinese Journal of Medical Imaging

基　　金：江苏省苏北人民医院院级基金资助项目(yzucms201223)

摘　　要：目的探讨不典型原发性输卵管癌(PCFT)和卵巢囊腺癌(OCA)的临床及CT影像特点,以提高其诊断率。资料与方法回顾性分析经手术病理证实的12例不典型PCFT患者(PCFT组)和20例OCA患者(OCA组)的CT检查和临床资料。比较两组患者血清CA125值、临床表现及CT特征。结果 PCFT组和OCA组CA125值分别为(486.13±23.89)U/ml和(1606.94±62.86)U/ml,差异有统计学意义(P<0.01)。PCFT组和OCA组阴道流血与阴道排液比较,差异有统计学意义(P<0.01)。PCFT组CT表现不规则实性肿块4例,囊实性肿块8例,无囊性肿块;OCA组无不规则实性肿块,囊实性肿块16例,囊性肿块4例;两组实性肿块、囊实性肿块比较差异有统计学意义(P<0.05)。两组患侧卵巢静脉直径、患侧子宫圆韧带直径、病灶体积、病灶增强扫描后静脉期与延迟期CT值比较差异均有统计学意义(P<0.05、P<0.01);两组转移淋巴结大小、病灶平扫与动脉期CT值差异无统计学意义(P>0.05)。结论平均血清CA125值、阴道流血与阴道排液等临床表现与患侧卵巢静脉直径、患侧子宫圆韧带直径、病灶体积、病灶增强扫描后静脉期与延迟期CT值相结合是诊断PCFT与OCA的鉴别要点。Purpose To summarize the CT features and clinical characteristics of atypical primary fallopian tube cancer （PCFT） and ovarian cystadenocarcinoma （OCA）, in order to improved the diagnosis. Materials and Methods CT findings and clinical data of 12 patients with atypical PCFT （PCFT group） and 20 patients with OCA （OCA group） were retrospectively studied. All patients were confirmed by pathology. Serum CA125 level, clinical characteristics and CT features of two groups were compared. Results Serum CA125 level of PCFT group and OCA group were （486.13±23.89） U/ml and （1606.94±62.86） U/ml, respectively. There was statistic difference between the two groups （P〈0.01）. There was significant differences on vaginal bleeding and vaginal discharge between the two groups （P〈0.01）. There were 4 cases with solid mass, 8 cases with cystic solid mass in PCFT group. And in OCA group, 16 cases with cystic solid mass and 4 cases with cystic mass were revealed, which showed statistic differences between the two groups （P〈0.05）. Some other findings also showed statistic differences including the diameter of ovarian vein on the affected side, the diameter of the round ligament of uterus on the affected side, tumor volume, and CT values of the mass in venous phase and delay phase （P〈0.05 or P〈0.01）. However, there were no statistic significance in the size of metastatic lymph nodes, the mean CT value of the mass on plain scan and in the arterial phase （P〉0.05）. Conclusion Clinical findings of serum CA125 level, vaginal bleeding, and vaginal discharge combine with imaging findings of diameter of the ovarian vein in the affected side, diameter of ipsilateral round ligament of uterus, tumor volume, CT values of the mass in venous and delay phase would be the key points for differential diagnosis of PCFT and OCA.

关 键 词：输卵管肿瘤 卵巢肿瘤 囊腺癌 体层摄影术 X线计算机 CA-125抗原 

分 类 号：R445.3[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]