Thomassin-Naggara Isabelle, Daraï Emile, Nassar-Slaba Jinane, Cortez Annie, Marsault Claude, Bazot Marc
Services de Radiologie, Hôpital Tenon, Paris, France.
J Comput Assist Tomogr. 2007 Mar-Apr;31(2):236-42. doi: 10.1097/01.rct.0000237810.88251.9e.
The purpose of this study was to assess the accuracy of magnetic resonance imaging (MRI), particularly, dynamic MRI, in distinguishing ovarian fibromas from subserous uterine leiomyomas.
Fifteen ovarian fibromas and 15 subserous uterine leiomyomas were retrospectively reviewed. All MR examinations included dynamic contrast-enhanced (DCE) sequences. Morphological criteria (size, T1 and T2 signals, ovarian tissue, associated uterine leiomyoma, and pelvic fluid), arterial vessels, time-intensity curves (maximal enhancement and signal intensity at 30, 60, and 90 seconds), and signal intensity on delayed T1-weighted images were compared between the 2 groups.
No significant difference in morphological criteria was noted between the 2 types of masses. Visualization of arterial vessels was more frequent in uterine leiomyomas than in ovarian fibromas (P= 0.002). The DCE MR enhancement rate was higher for uterine leiomyomas than for ovarian fibromas in terms of both maximal enhancement (P < 0.001) and enhancement rate at 30 (P = 0.009), 60 (P = 0.007), and 90 seconds (P = 0.0009). On delayed T1 postcontrast sequence, no statistical difference exists between signal intensity of ovarian fibromas and uterine leiomyomas.
Our findings suggest that DCE MRI can distinguish ovarian fibromas from uterine leiomyomas and should be used if sonography fails to show the origin of a pelvic mass.
本研究旨在评估磁共振成像(MRI),尤其是动态MRI,在鉴别卵巢纤维瘤与浆膜下子宫肌瘤方面的准确性。
回顾性分析15例卵巢纤维瘤和15例浆膜下子宫肌瘤。所有MR检查均包括动态对比增强(DCE)序列。比较两组在形态学标准(大小、T1和T2信号、卵巢组织、合并的子宫肌瘤及盆腔积液)、动脉血管、时间-强度曲线(30、60和90秒时的最大强化及信号强度)以及延迟T1加权图像上的信号强度。
两种类型肿块在形态学标准上无显著差异。子宫肌瘤中动脉血管的显示比卵巢纤维瘤更常见(P = ০.০০২)。在最大强化(P < ০.০০১)以及30秒(P = ০.০০৯)、60秒(P = ০.০০৭)和90秒(P = `০.০০০৯)时的强化率方面,子宫肌瘤的DCE MR强化率均高于卵巢纤维瘤。在延迟T1增强序列上,卵巢纤维瘤与子宫肌瘤的信号强度无统计学差异。
我们的研究结果表明,DCE MRI能够鉴别卵巢纤维瘤与子宫肌瘤,并且在超声检查未能显示盆腔肿块起源时应予以应用。