卵巢浆液性乳头状囊腺瘤的MRI表现与病理对照  

Ovarian serous papillary cystadenoma:MRI findings and correlation with pathology

作　　者：马凤华 田晓梅 张国福 MA Feng-hua;TIAN Xiao-mei;ZHANG Guo-fu(Department of Radiology,Obstetrics&Gynecology Hospital,Fudan University,Shanghai 20001l,China)

机构地区：[1]复旦大学附属妇产科医院放射科,上海200011

出　　处：《中国临床医学影像杂志》2025年第2期117-120,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:分析卵巢浆液性乳头状囊腺瘤(SPC)的MRI表现,提高对该病的认识。方法:对30例共31个SPC行术前MRI扫描,观察肿瘤的部位、形态、大小、囊液信号、囊壁及分隔厚度、结节或乳头状突起、实性区域和增强表现,结果与病理对照。结果:30例单侧29例,双侧1例,所有病例均为囊性为主肿块,肿瘤边界清,最大径2.2~13.7 cm,平均(5.6±2.3)cm。29例患者采用腹腔镜下囊肿剥除或附件切除,1例患者经腹囊肿剥除。术前MR约51.6%诊断为良性肿瘤,诊断交界性或恶性肿瘤约占48.4%。单房囊性肿块20个(64.5%),7个囊液呈T_(1)WI稍高、T_(2)WI高信号;13个囊液呈T_(1)WI低、T_(2)WI高的水样信号;囊壁薄而均匀,囊壁单个或多个乳头状突起,大小约0.4~3.4 cm,均呈T_(2)WI低信号;多房囊性肿块10个(32.3%),单侧9例,双侧1例,3个囊液呈T_(1)WI稍高、T_(2)WI高信号;7个囊液呈T_(1)WI低、T_(2)WI高的水样信号。囊壁薄而均匀,1个囊壁未见乳头状突起,9个囊壁见单个或多个乳头状突起,大小约0.9~3.1 cm,6个呈T_(2)WI低信号,3个呈T_(2)WI稍高信号;实性肿瘤1个(3.2%),单侧、表面乳头状表现,呈T_(1)WI低、T_(2)WI稍高信号,增强后明显强化。结论:SPC典型表现为单房或多房囊性肿块,伴囊壁单个或多个乳头状突起,T_(2)WI低信号并轻度强化为其特征性表现。Objective:To investigate MRI findings of ovarian serous papillary cystadenoma(SPC)to improve the diagnosis of SPC.Materials and Methods:Thirty patients with 31 SPC preoperatively underwent MRI.Images were evaluated and correlated with pathology for the location,shape,size,loculation,signal intensity,thickness of the wall and septation,nodules or vegetations and solid area.Results:In 30 cases,29 were unilateral and 1 was bilateral.All cases were cystic masses with clear boundaries,and with average diameter of(5.6±2.3)cm(maximum diameter:2.2~13.7 cm).Twenty-nine patients underwent laparoscopic or adnexal excision,and one patient underwent abdominal excision.About 51.6%of the patients were diagnosed with benign tumors and 48.4%were diagnosed with borderline or malignant tumors.There were 20 single-locular cystic tumors,and the cyst fluid of 7 cystic masses showed slightly high signal on T_(1)WI and high signal on T_(2)WI.The cyst fluid of13 cystic masses showed the same signal intensity as water with low signal on T_(1)WI and high signal on T_(2)WI.The cyst wall was thin and smooth with single or multiple papillary projections(about 0.4~3.4 cm in size)of low T_(2)WI signal.There were 10multilocular cystic masses,9 unilateral cases and 1 bilateral case.The cyst fluid of 3 cystic masses showed slightly high signal on T_(1)WI and high signal on T_(2)WI.The cyst fluid of 7 cystic masses showed the same signal intensity as water with low high signal on T_(1)WI and high signal on T_(2)WI.The cyst walls were thin and smooth.No papillary projection was found in 1cyst wall,and single or multiple papillary projections were found in 9 cyst walls,with the size of 0.9~3.1 cm.On T_(2)WI,papillary projections showed low signals in 6 cases,slightly high signals in 3 cases.There was one solid mass with unilateral,superficial papillary appearance,low signal on T_(1)WI,slightly high signal on T_(2)WI,and obvious enhancement after enhancement.Conclusion:The characteristic MRI findings are a unilocular or multilocular cystic mass with

关 键 词：囊腺瘤 乳头状 卵巢肿瘤 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]