卵巢透明细胞癌与高级别浆液性癌的磁共振鉴别诊断  

Magnetic resonance imaging for distinguishing ovarian clear cell carcinoma from high-grade serous carcinoma

作　　者：黄丹萍[1] 蔺红梅[2] 刘灶松[1] 杨蕊梦[1] 魏新华[1] 江新青[1] HUANG Dan-ping;LIN Hong-mei;LIU Zao-song(Department of Radiology,Guangzhou First People's Hospital,School of Medicine,South China University of Technology,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院医学影像部,广州510180 [2]中山大学附属第三医院体检中心,广州510630

出　　处：《放射学实践》2020年第11期1464-1468,共5页Radiologic Practice

基　　金：2020年广州市卫生健康科技项目(20201A010003)。

摘　　要：目的:探讨卵巢透明细胞癌(CCC)与高级别浆液性癌(HGSC)的临床及MRI特征,评价MRI对CCC与HGSC的鉴别诊断价值。方法:回顾性分析2013年11月-2019年11月经手术和病理确诊的21例CCC及32例HGSC患者的临床及MRI资料,临床资料包括患者年龄、肿瘤大小、患者绝经状态、肿瘤发生部位偏侧性、实验室指标、有无合并子宫内膜异位症及国际妇产科联盟(FIGO)分期,MRI表现包括肿瘤形态、囊实性组成、囊性成份内有无T1高信号、单囊或多囊、囊内有无壁结节及其形态、实性成份强化程度,有无腹膜种植转移,有无淋巴结转移,有无盆腹腔积液。分析比较CCC与HGSC的临床及MRI特征。结果:CCC与HGSC在肿瘤发生部位偏侧性、平均最大径、形态、组成成份、囊性成份内T1高信号、单囊、囊内壁结节形态、CA199升高、合并子宫内膜异位症、FIGO分期及腹膜种植转移方面的差异具有统计学意义(P值分别为0.041、0.01、0.016、0.028、0.036、0.001、0.029、0.002、0.004、0.003、0.004),相对于HGSC,CCC患者肿瘤形态更规则(13/24,54%vs.11/44,25%;P=0.016),囊实性(15/24,62.5%vs.22/44,50%;P=0.022)并以单囊为主(17/24,71%vs.13/44,30%;P=0.001),单侧发病多见(18/21,86%vs.19/32,59%;P=0.041),肿块平均最大径更大(120.1±51.9 mm vs.84.4±36.1 mm,P=0.01),肿瘤囊内结节形态以结节或乳头状突起为主(10/13,77%vs.9/23,39%,P=0.029),肿瘤囊性成份T1WI高信号多见(10/24,42%vs.8/44,18%;P=0.036),腹膜种植转移更少见(6/21,29%vs.22/32,69%;P=0.004)。结论:CCC与HGSC的临床资料及MRI表现具有一定特征,MRI能较好地鉴别两者。Objective:To compare the clinical characteristics and MRI features of ovarian clear cell carcinoma(CCC)and high-grade serous carcinoma(HGSC),to distinguish CCC from HGSC.Methods:The clinical characteristics and MRI features of 21 patients with CCC and 32 patients with HGSC confirmed by surgery and pathology were retrospectively analyzed between November 2013 and November 2019.Clinical data included age,tumor size,menopausal status,tumor laterality,laboratory indicators,endometriosis and International Federation of Gynecology and Obstetrics(FIGO)stage,MRI features included shape,configuration,T1-hyperintense cystic components,unilocular,papillary projection and its shape,the degrees of enhancement of a solid component,peritoneal implantation,lymphadenopathy and ascites.Results:There was a statistically significant difference between CCC and HGSC in laterality,the mean maximum diameter,shape,configuration,T1-hyperintense cystic components,unilocular,shape of papillary projection,the increased CA199 level,endometriosis,FIGO stage and peritoneal implantation(P=0.041、0.01、0.016、0.028、0.036、0.001、0.029、0.002、0.004、0.003、0.004,respectively),compared to HGSCs,CCCs were more frequently regular in shape(13/24,54%vs.11/44,25%;P=0.016),more often solid-cystic(15/24,62.5%vs.22/44,50%;P=0.022),unilocular(17/24,71%vs.13/44,30%;P=0.001)and unilateral(18/21,86%vs 19/32,59%;P=0.041),had longer mean maximum diameter(120.1±51.9mm vs.84.4±36.1mm;P=0.005),had mural nodules or papillary projections more often(10/13,77%vs.9/23,39%;P=0.029),had T1-hyperintense cystic components more often(10/24,42%vs.8/44,18%;P=0.036)and were peritoneally implanted less frequently(6/21,29%vs.22/32,69%;P=0.004).Conclusion:CCC and HGSC had typical clinical characteristics and MR features.MRI could be helpful for distinguishing CCC from HGSC.

关 键 词：卵巢肿瘤 透明细胞癌 高级别浆液性癌 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]