DWI在卵巢卵泡膜-纤维瘤与浆膜下子宫肌瘤鉴别诊断中的应用价值  

Application value of DWI in differential diagnosis of ovarian follicular fibroblastoma and subserosal hysteromyoma

作　　者：谭丽 赵一蓉[1] 方玉[1] 冯晨 TAN Li;ZHAO Yirong;FANG Yu;FENG Chen(Department of Radiology,Chongqing Municipal Hospital of Traditional Chinese Medicine,Chongqing 400021,China)

机构地区：[1]重庆市中医院放射科,400021

出　　处：《现代医药卫生》2019年第7期976-978,984,共4页Journal of Modern Medicine & Health

基　　金：重庆市科研院所绩效激励引导专项项目(cstc217jxjl0123);重庆市中医院院内培育课题项目(2016-1-34)

摘　　要：目的探讨磁共振扩散加权成像(DWI)在卵巢卵泡膜-纤维瘤与浆膜下子宫肌瘤鉴别诊断中的应用价值。方法收集2016年6月至2018年6月该院收治的经手术及病理检查证实并有完整记录及术前影像学资料的15例卵巢卵泡膜-纤维瘤和13例浆膜下子宫肌瘤患者的临床资料。分析在常规磁共振成像(MRI)成像序列结合DWI及表观扩散系数(ADC)的影像学征象。结果 15例卵巢卵泡膜-纤维瘤患者均为T1WI等、低信号,T2WI主体低信号,其中呈斑片絮状高信号6例,内有不均匀稍高信号9例,磁共振动态对比增强延迟轻-中度强化14例,明显强化只有1例,DWI呈中-高信号11例(73.3%),ADC值不同程度降低。13例浆膜下肌瘤患者均表现为T1WI低信号、T2WI低信号内夹杂斑片状稍高信号,DWI呈稍高信号3例(23.1%),ADC值稍减低,磁共振动态对比增强明显强化同子宫肌层8例,轻-中度强化5例。结论 DWI信号改变作为补充条件对卵巢卵泡膜-纤维瘤与浆膜下肌瘤的鉴别诊断具有一定应用价值。Objective To investigate the application value of magnetic resonance diffusion-weighted imaging(DWI) in the differential diagnosis of ovarian follicular membrane fibroma and subserosal hysteromyoma. Methods The clinical data in 15 cases of ovarian follicular membrane fibroma and 13 cases of subserosal hysteromyoma confirmed by operation and pathologic examination,who had the intact records and preoperative imageologic data,were collected.The imageologic signs of the conventional MRI sequence combined with DWI and apparent diffusion coefficient(ADC) diagram were analyzed. Results All 15 cases of ovarian membrane fibroma had equisignal and low signal on T1WI,and low signal on T2WI main part,6 cases showed the patch and patcky high signal.In 9 cases,there were nonuniform and slightly hyperintense signal in MRI-DCE,there were 14 cases of delayed mild-moderate enhancement and only 1 case of obvious enhancement,among them 11 cases(73.3%) had slightly high signal-high signal on DWI,the ADC value was decreased in varying degrees.In 13 cases of subserous myoma,all showed low signal on T1WI,low signal on T2WI with patchy and slightly high signal.There were 3 cases(23.1%) of slightly high signal on DWI and the ADC value was slightly low.In MRI-DCE,8 cases of obvious enhancement were consistent with that of myometrium.Mild to moderate enhancement was found in 5 cases. Conclusion The change of MR-DWI signal as a complementary condition has a certain application value for the differential diagnosis of ovarian follicular membrane fibroma and subserosal hysteromyoma.

关 键 词：磁共振成像 卵巢肿瘤 卵泡 纤维瘤 子宫肿瘤 平滑肌瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学]