卵巢恶性上皮源性肿瘤影像学鉴别诊断  

Malignant epithelial tumors of the ovary：differential diagnosis with CT and MR imaging

作　　者：李胜开[1] 袁晓丹 代海洋[1] 周玉祥[1] 刘国荣[1] LI Shengkai;YUAN Xiaodan;DAI Haiyang;ZHOU Yuxiang;LIU Guorong(Department of Radiology, Huizhou Municipal Central Hospital, Huizhou 516001, China)

机构地区：[1]惠州市中心人民医院放射科,广东惠州516001

出　　处：《实用放射学杂志》2018年第6期920-923,共4页Journal of Practical Radiology

摘　　要：目的 探讨卵巢恶性上皮源性肿瘤各亚型影像学鉴别诊断价值，提高对卵巢癌影像学表现的认识。方法 回顾性分析54例术前行相关影像学检查，并经临床手术病理证实为卵巢恶性上皮源性肿瘤病例，观察其影像学表现并总结分析。结果 34例为卵巢囊腺癌，其中浆液性囊腺癌26例（48%），黏液性囊腺癌8例（14%），内膜样癌及透明细胞癌各10例（分别19%）。影像表现均为单房或多房囊实性肿块，但肿块内钙化情况、实性结节大小、肿瘤分房情况、是否合并大量腹腔积液以及邻近结构受累情况存在一定差异。囊腺癌中5例出现钙化成分，而子宫内膜样癌及透明细胞癌均未见钙化灶；透明细胞癌实性成分比例较少，一般表现为腔内结节隆起；子宫内膜样癌常合并子宫内膜增生或子宫内膜癌，三者中其最易出现周围侵犯、粘连。结论 卵巢恶性上皮源性肿瘤各亚型在分房情况、囊壁结节及瘤体实性结节大小及钙化情况存在一定特征差异,对比分析这些细节特征，能帮助临床做出更精确的术前诊断。Objective To investigate the value of CT and MRI in the differential diagnosis of various subtypes malignant epithelial tumors of the ovary, to improve the understanding of imaging manifestations of ovarian cancer. Methods Fifty four cases with malignant epithelial tumors of the ovary confirmed by clinical operation and pathology were included in this study and preoperative imaging examinations were analyzed retrospectively. Results Thirty four cases were diagnosed as ovary cystadenoma, including 26 cases of serous cystadenoma （48%） , 8 cases of mucous cystadenoma （14%） , 10 cases of endometrioid adenocarcinoma （19%） and 10 cases of clear-cell carcinoma （19%）. All the tumors appeared as unilocular or multilocular cystic-solid masses, however some differences existed among tumors in calcification in masses, size of solid nodules, locular appearance,with or without associated massive ascites, and adjacent structures involvement .Calcification occurred in 5 cases of cystadenocarcinoma, and no calcification was found in endometrioid adenocarcinoma or clea〉cell carcinoma.The proportion of solid component in clear-cell carcinoma was lower, usually presenting as intralumimal nodular protuberance. Endometrioid adenocarcinoma was often associated with endometrial hyperplasia or endometrial carcinoma and was the most prone to peripheral invasion and adhesion. Conclusion The different subtypes of ovary malignant epithelium-derived tumor have different characteristics of multilocular,the size of cyst wall nodule or solid nodule and the calcification.Compare and analysis of these characteristics help us to make a more accurate preoperative diagnosis.

关 键 词：卵巢肿瘤 上皮源性肿瘤 计算机体层成像 磁共振成像 

分 类 号：R737.31[医药卫生—肿瘤] R814.42[医药卫生—临床医学]