妊娠合并卵巢肿块的MR诊断与鉴别诊断  

The value of MR imaging in diagnosis and differential diagnosis of ovarian masses in pregnancy

作　　者：马凤华 强金伟[2] MA Feng-hua;QIANG Jin-wei(Department of Radiology,Obstetrics&Gynecology Hospital,Fudan University,Shanghai 200090,China;Jinshan Hospital,Fudan University,Shanghai 201508,China)

机构地区：[1]复旦大学附属妇产科医院放射科,上海200090 [2]复旦大学附属金山医院,上海201508

出　　处：《中国临床医学影像杂志》2024年第12期866-870,共5页Journal of China Clinic Medical Imaging

基　　金：第七周金山区医学重点专科A类——影像医学科(编号:JSZK2023A02)。

摘　　要：目的:分析妊娠期卵巢肿块的MRI特征,探讨MRI对妊娠期卵巢肿块的鉴别诊断价值。材料与方法:回顾性分析经手术和病理证实的42例妊娠期卵巢肿块患者的MRI资料,观察病灶的部位、形态、大小、质地、信号强度,并与病理资料一一对照分析。结果:42名孕妇共计48个卵巢肿块,单侧36例,双侧6例;直径3.1~20 cm,平均(9.9±4.3)cm。纯囊性25个(52.0%),囊性为主伴壁结节8个(16.7%),囊实性8个(16.7%),实性7个(14.6%)。组织学类型包括恶性肿瘤4个(8.3%,分别为无性细胞瘤、混合型生殖细胞肿瘤、黏液腺癌和混合型腺癌);交界性肿瘤5个(10.4%,浆液性3个、黏液性2个);良性病变39个(81.3%),包括纤维瘤4个、囊腺瘤10个(浆液性3个、黏液性7个)、成熟性畸胎瘤7个、卵巢内膜样囊肿12个、双侧卵巢黄素化滤泡囊肿2个、子宫肌瘤2个、附件扭转2个。结论:妊娠期卵巢肿块以良性囊性肿瘤为主,实性成分、壁结节或囊实性肿块提示交界性或恶性肿瘤;MRI有助于妊娠期卵巢肿块的鉴别诊断。Objective:To investigate the magnetic resonance imaging(MRI)features of ovarian masses during pregnancy and to evaluate the diagnostic value of MRI in differential diagnosis of ovarian tumors during pregnancy.Materials and Methods:MRI data of 42 pregnant patients with ovarian masses confirmed by surgery and pathology were retrospectively analyzed.The location,morphology,size,texture and signal intensity of the lesions were observed and compared with pathological data.Results:A total of 48 cases of ovarian masses were found in 42 pregnant women,including 36 unilateral and 6 bilateral masses with diameter of 3.1~20 cm(mean(9.9±4.3)cm).There were 25 cases(52.0%)of pure cystic masses,8 cases(16.7%)of mainly cystic masses with mural nodules,8 cases(16.7%)of cystic-solid masses and 7 cases(14.6%)solid masses.The histological types included 4 cases of malignant tumor(8.3%,namely dysgerminoma,mixed germ cell tumor,mucinous adenocarcinoma and mixed adenocarcinoma).Five cases of borderline tumor(10.4%,3 serous and 2 mucinous tumors).Thirty-nine cases of benign lesions(81.3%)including 4 fibromas,10 cystadenomas(3 serous,7 mucinous),7 mature teratomas,12 ovarian endometriotic cysts,2 bilateral ovarian luteinized follicular cysts,2 uterine fibroids and 2 adnexal torsion.Conclusion:Benign cystic tumor is the dominant ovarian mass during pregnancy,while solid components,mural nodules or cystic solid masses indicate borderline or malignant tumors.MRI is helpful for the differential diagnosis of ovarian masses during pregnancy.

关 键 词：卵巢肿瘤 妊娠 磁共振成像 

分 类 号：R737.31[医药卫生—肿瘤] R445.2[医药卫生—临床医学]