Cai Song Qi, Ma Feng Hua, Qiang Jin Wei, Zhao Shu Hui, Zhang Guo Fu, Rao Ya Min
From the *Department of Radiology, Jinshan Hospital, and Departments of †Radiology and ‡Pathology, Obstetrics & Gynecology Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
J Comput Assist Tomogr. 2015 Mar-Apr;39(2):270-5. doi: 10.1097/RCT.0000000000000178.
The aim of this study was to investigate the magnetic resonance (MR) and diffusion-weighted (DW) imaging characteristics of primary fallopian tube carcinoma (PFTC).
The clinical, MR, and DW imaging characteristics and pathologic findings of 23 patients with 27 tumors were studied retrospectively. The MR and DW imaging appearance of tumors including laterality, size and shape, architecture, signal intensity, apparent diffusion coefficient (ADC) value, enhancement pattern, hydrosalpinx, and intrauterine fluid collection were evaluated and correlated with pathologic findings.
Histopathologically, all 27 tumors were serous carcinoma with a unilateral tumor in 19 patients and bilateral tumors in 4 patients. Thirteen patients (57%) with PFTC were misdiagnosed preoperatively, 10 of which as epithelial ovarian carcinoma. The mean (SD) largest diameter was 61 (7) mm. The tumor shape was fusiform, sausagelike, or serpentine in 19 patients (70%) and nodular or irregular in 8 patients (30%). Twenty (74%) of the 27 tumors were solid, and 7 (26%) were cystic-solid. The solid components showed hypointensity to isointensity on T1-weighted imaging, and isointensity to slight hyperintensity on T2-weighted imaging. There were obvious hyperintensity on DW imaging; obvious hypointensity on ADC maps with a mean (SD) ADC value of 0.79 (0.22) × 10 mm; and mild (8/27, 30%), moderate (13/27, 48%), and marked (6/27, 22%) enhancement on contrast-enhanced imaging. Ipsilateral hydrosalpinx, intrauterine fluid collection, and ascites were found in 14 tumors (52%) and 7 (30%) and 5 (22%) patients, respectively.
The PFTC has some characteristic MR imaging features. The DW imaging, ADC maps, and ADC values are helpful for the detection and differentiation of PFTC from other pelvic masses.
本研究旨在探讨原发性输卵管癌(PFTC)的磁共振(MR)及扩散加权(DW)成像特征。
回顾性研究23例患者27个肿瘤的临床、MR及DW成像特征和病理结果。评估肿瘤的MR及DW成像表现,包括肿瘤位置、大小和形态、结构、信号强度、表观扩散系数(ADC)值、强化方式、输卵管积水及宫腔积液情况,并与病理结果进行对照。
组织病理学检查显示,27个肿瘤均为浆液性癌,19例为单侧肿瘤,4例为双侧肿瘤。13例(57%)PFTC患者术前被误诊,其中10例被误诊为上皮性卵巢癌。肿瘤最大直径的均值(标准差)为61(7)mm。19例(70%)患者肿瘤形态为梭形、腊肠样或蛇形,8例(30%)为结节状或不规则形。27个肿瘤中20个(74%)为实性,7个(26%)为囊实性。实性成分在T1加权成像上呈低信号至等信号,在T2加权成像上呈等信号至轻度高信号。DW成像上呈明显高信号;ADC图上呈明显低信号,ADC值的均值(标准差)为0.79(0.22)×10⁻³mm²;增强成像上呈轻度(8/27,30%)、中度(13/27,48%)和明显(6/27,22%)强化。分别在14个肿瘤(52%)、7例(30%)和5例(22%)患者中发现同侧输卵管积水、宫腔积液及腹水。
PFTC具有一些特征性的MR成像表现。DW成像、ADC图及ADC值有助于PFTC的检出及与其他盆腔肿块的鉴别。