原发性输卵管浆液性癌的多参数MRI表现及临床病理对照分析  

Primary fallopian tube carcinoma:multiparameter magnetic resonance characteristics and pathological correlation

作　　者：方如旗[1] 翁淑萍[1] 章国伟 陈霞平[1] 周作福[1] FANG Ruqi;WENG Shuping;ZHANG Guowei;CHEN Xiaping;ZHOU Zuofu(Department of Radiology,Fujian Maternity and Child Health Hospital,Fuzhou 350001,China)

机构地区：[1]福建省妇幼保健院影像科,福建福州350001

出　　处：《医学影像学杂志》2023年第10期1844-1848,共5页Journal of Medical Imaging

基　　金：福建省卫生健康科研人才培养项目(中青年骨干人才培养项目)(编号:2019-ZQN-26)。

摘　　要：目的探讨原发性输卵管浆液性癌(primary fallopian tube carcinoma,PFTC)的MRI表现及与病理相关性。方法选取10例经手术病理证实的PFTC的MRI资料,分析MRI表现,包括病灶部位、形状、构成、大小、信号强度、强化情况、淋巴结转移、盆腔转移及典型征象。同时分析DWI和DCE特征以及临床病理特征。结果PFTC 10例患者,病灶11个,主要临床症状:阴道出血6例,腹部肿块6例。MRI肿瘤呈腊肠型7例,菜花型结节3例,分叶状1例。11个病灶肿瘤实性部分T_(1)WI呈低信号,T_(2)WI呈稍高信号,DWI呈明显高信号,5个病灶可见轻到中度强化,动态曲线呈II型,所有患者均可见“输卵管残余征”,5例增强扫描的患者可见“假包膜征”。结论PFTC表现为附件区肿块伴“输卵管残余征”及“假包膜征”;DWI及DCE对诊断原发性输卵管浆液性癌有一定的帮助。Objective To explore characteristic magnetic resonance imaging(MRI)features of primary fallopian tube carcinoma(PFTC)with pathological correlation.Methods Ten patients with pathologically confirmed PFTC were retrospectively reviewed.The conventional MRI features were analyzed,including laterality,shape,size,signal-intensity,contrast enhancement,lymph node metastasis,pelvic metastasis and typical signs.We also analyzed the diffusion-weighted imaging(DWI)and dynamic contrast-enhanced(DCE)MRI features and the clinical and pathological informations of PFTCs.Results Eleven tumors in ten patients were evaluated.The main clinical manifestation were vaginal discharge(n=6)and palpable adnexal mass(n=6).In MR imaging,the tumor showed sausage-shaped(n=7),cauliflower-shape nodular(n=3)or lobulated(n=1)morphology.The solid portion was hypointense intensity on T_(1)-weighted imaging(T_(1)WI)(n=11),slightly hyperintense(n=11)on T_(2)-weighted imaging(T_(2)WI),with highly hyperintense on DWI(n=11).Minimal-to-mild contrasted enhancement was detected in five tumors with type II signal intensity curve(n=5).The“vestigital fallopian tube signs”were found in all eleven tumors(n=11),and“pseudocapsule signs”were detected in all 5 tumors with contrasted enhanced MRI.Conclusion PFTC might manifest as adnexal solid masses with“vestigital fallopian tube sign”and“pseudocapsule sign”in preoperative imaging.DWI and DCE-MRI may be a promising tool for the diagnosis of PFTC.

关 键 词：原发性输卵管肿瘤 磁共振成像 扩散加权成像 动态增强成像 

分 类 号：R737.32[医药卫生—肿瘤] R445.2[医药卫生—临床医学]