磁共振成像鉴别良性与交界性上皮性卵巢肿瘤的价值  

Value of MRI in differentiating benign and borderline epithelial ovarian tumors

作　　者：陈超琪 谢艺才 叶丹枫[1] 江布英 蒙海明 Chen Chaoqi;Xie Yicai;Ye Danfeng;Meng Haiming(Medical Imaging Department,Wuzhou Red Cross Hospital,Guangxi543002,China;不详)

机构地区：[1]广西壮族自治区梧州市红十字会医院医学影像科,543002 [2]广西壮族自治区梧州市红十字会医院妇产科,543002

出　　处：《实用医学影像杂志》2023年第3期172-176,共5页Journal of Practical Medical Imaging

基　　金：广西壮族自治区梧州市科技计划项目(202102073)。

摘　　要：目的探讨磁共振成像(MRI)对于良性与交界性上皮性卵巢肿瘤的鉴别诊断价值。方法回顾性分析经手术病理证实的25例良性上皮性卵巢肿瘤患者和25例交界性上皮性卵巢肿瘤患者(良性肿瘤29个、交界性肿瘤31个)的术前MRI表现及临床资料,观察和比较肿瘤的形态、大小、分房、肿瘤基质、囊液信号、病灶边界、囊壁及分隔的厚度、强化程度、扩散加权成像、时间-信号强度(TIC)曲线类型、腹腔积液及腹膜种植灶、同侧卵巢显示等情况,结果与病理对照。结果2组肿瘤在其大小和累及双侧性差异上无统计学意义(P=0.333,P=0.480);2组肿瘤在肿瘤基质(囊性、囊实性)、蜂窝状子房、T_(2)WI呈单一高信号、T_(2)WI含低信号、囊壁或分隔厚度、腹腔积液及腹膜种植灶7个征象差异有统计学意义(P<0.05),其中T_(2)WI呈单一高信号及肿瘤基质为完全囊性仅见于良性上皮性卵巢肿瘤,腹膜种植灶及肿瘤基质为囊实性仅见于交界性上皮性卵巢肿瘤,蜂窝状子房(P=0.006)、T_(2)WI含低信号(P<0.001)、腹腔积液(P=0.015)。另外2组肿瘤在表观弥散系数(ADC)值与囊壁及分隔厚度上差异也具有统计学意义,P值均<0.001,受试者工作特征曲线(ROC)分析结果显示,肿瘤实性部分ADC值的最佳诊断阈值为1.25×10^(-3) mm^(2)/s,ROC曲线下面积(AUC)为0.892,诊断灵敏度、特异度为89.7%、79.3%;肿瘤囊壁或分隔厚度的最佳诊断阈值为4.5 mm,AUC为0.882,诊断灵敏度、特异度为80.6%、86.2%。结论MRI可以很好地显示良性与交界性上皮性卵巢肿瘤的不同影像学征象,有助于术前两者的鉴别及手术方案的制订。Objective To investigate the value of MRI in the differential diagnosis of benign and borderline epithelial ovarian tumors.Methods Preoperative MRI findings and clinical data of 25 patients with benign epithelial ovarian tumor and 25 patients with borderline epithelial ovarian tumor(29 benign tumors and 31 borderline tumors)confirmed by surgery and pathology were retrospectively analyzed.The morphology,size,differentiation,tumor stroma,cyst fluid signal,clarity of lesion boundary and cystic intersexual interface,thickness of cyst wall and separation,degree of enhancement,diffusion-weighted imaging,time-intensity curve(TIC)types,abdominal effusion and peritoneal implant foci,and ipsilateral ovarian display were observed and compared.Results There was no significant difference in tumor size and bilateral involvement between the two groups(P=0.333,P=0.480).There were statistically significant differences between the two groups in tumor matrix(cystic,cystic solid),honeycomb ovary,T_(2)WI with single high signal,T_(2)WI with low signal,cyst wall or separation thickness,abdominal effusion and peritoneal implant lesions(P<0.05),among which T_(2)WI with single high signal and tumor matrix with complete cystic were only found in benign epithelial ovarian tumors.Peritoneal implants and tumor stroma are cystic and solid only seen in borderline epithelial ovarian tumors.Honeycomb ovary(P=0.006),T_(2)WI with low signal(P<0.001),peritoneal effusion(P=0.015).The other two groups of tumors also had statistically significant differences in ADC values and the thickness of the cyst wall and separation,with P<0.001.ROC curve analysis results showed that the optimal diagnostic threshold of ADC values in the solid part of the tumor was 1.25×10^(-3) mm^(2)/s.AUC was 0.892,diagnostic sensitivity and specificity were 89.7% and 79.3%.The optimal diagnostic threshold was 4.5 mm,AUC was 0.882,and diagnostic sensitivity and specificity were 80.6% and 86.2%.Conclusion MRI can well display the different imaging signs of benign and borderline

关 键 词：交界性 良性 卵巢上皮性肿瘤 磁共振成像 对比 

分 类 号：R737.31[医药卫生—肿瘤]