超声及MRI诊断卵巢表面浆液性交界性乳头状瘤的价值  

Value of ultrasonography and MRI in diagnosis of ovarian serous surface papillary borderline tumors

作　　者：肖喜荣[1] 陈秀英[1] 王士甲[2] 符忠蓬 孙莉 

机构地区：[1]复旦大学附属妇产科医院妇科,上海200011 [2]复旦大学附属妇产科医院放射科,上海200011 [3]复旦大学附属妇产科医院超声科,上海200011

出　　处：《肿瘤影像学》2015年第2期129-133,共5页Oncoradiology

摘　　要：目的:总结卵巢表面浆液性交界性乳头状瘤(SSPBT)的超声及MRI特点,探讨超声和MRI诊断SSPBT的价值。方法:回顾性分析8例SSPBT患者的病史,总结其临床特征、超声表现及MRI特征,以术中所见及术后病理为标准,比较超声与MRI诊断SSPBT的价值。结果:患者平均年龄(30.3±5.3)岁(25~44岁),7例(87.5%)血清糖类抗原125(CA125)升高,2例(25.0%)血清CA19-9升高,癌胚抗原(CEA)均在正常范围。双侧肿块8例,其中5例为双侧SSPBT;2例一侧为SSPBT,对侧为卵巢浆液性交界性乳头状瘤;1例一侧为SSPBT,对侧为卵巢浆液性囊腺瘤。SSPBT患者卵巢表面赘生物多呈菜花样、乳头状、粟粒样等表现。术前B超均提示单侧或双侧肿块,其中5枚SSPBT(38.5%,5/13)在肿块内或肿块旁见卵巢或卵巢样组织,1枚提示卵巢边界不清,2枚漏诊,2枚误诊为输卵管来源肿瘤。肿瘤最大径线平均值为(96.1±22.7)mm,多表现为中低、中等或混合回声,6枚提示星点状或条索状血流信号。术前MRI提示肿块以囊实性为主,多见分隔和乳头。囊性成分T1WI低信号或稍高信号,T2WI高信号;实性成分T1WI等信号,T2WI等信号或高信号。增强后实性成分明显强化,囊性成分无强化。结论:SSPBT发病年龄轻,双侧多发,超声诊断早期SSPBT可能比MRI更有优势。Objective: To detect the characteristics of ultrasonography and MRI of ovarian serous surface papillary borderline tumor(SSPBT), and to evaluate the value of ultrasonography and MRI in the diagnosis of SSPBT. Methods: 8 women with SSPBT from Obstetrics and Gynecology Hospital, Fudan University during 2010 and 2013 were retrospectively analyzed, and their clinical information and characteristics of ultrasonography and MRI were compared with operation and pathology. Results: Of the 8 women, the median age was(30.3±5.3) years old(range 25-44). Carbohydrate antigen 125(CA125) was elevated in 7 cases(87.5%), and CA19-9 in 2 cases. The level of carcinoembryonic antigen(CEA) was normal in all patients. With respect to the pathology, 5 cases had SSPBT in both ovaries, 2 cases had SSPBT in one ovary and serous cystic tumor of borderline malignancy in the contralateral ovary, and 1 case had SSPBT in one ovary and serous cystadenoma in the contralateral ovary. The ovaries involved were usually covered by neoplasm-like cauliflower, papilla or millet, and some manifested cystic ovaries or hyperblastosis. Preoperative ultrasonography showed unilateral or bilateral masses in all patients. Ovarian tissue was detected beside or in the masses in 5 SSPBTS(38.5%, 5/13). The boundary of the ovary was not clear in 1 mass. 2 masses were miss-diagnosed. The median diameter of the masses was(96.1±22.7) mm. Most masses displayed medium or low or mixed echo in ultrasound and blood flow was detected with Doppler ultrasound in 6 masses. MRI suggested that the cystic or solid masses were the main form. The cystic part of the mass showed hypointensity or slight hyperintensity on T1 WI and hyperintensity on T2 WI. The solid component showed isointensity on T1 WI and isointensity/hyperintensity on T2 WI. With contrast agent, the solid component but not cystic component showed obvious enhancement. Conclusion: Most patients with SSPBT are in child-bearing period and both ovaries are usually involved. Ultrasonography may have more advantages than

关 键 词：浆液性肿瘤 交界性肿瘤 乳头 超声 磁共振扫描 

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