Li Hai Ming, Qiang Jin Wei, Xia Gan Lin, Zhao Shu Hui, Ma Feng Hua, Cai Song Qi, Feng Feng, Fu Ai Yan
Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, 1508 Longhang Road, Shanghai, 201508, China.
Department of Radiology, Nantong Cancer Hospital, Nantong University, 30 North Tongyang Road, Tongzhou District, Nantong, Jiangsu, 226361, China.
J Ovarian Res. 2015 Apr 30;8:26. doi: 10.1186/s13048-015-0154-2.
To investigate magnetic resonance imaging (MRI) features for differentiating ovarian endometrioid adenocarcinoma (OEC) from high-grade serous adenocarcinoma (HGSC).
Twenty-three patients with 25 OECs and 93 patients with 139 HGSCs confirmed by surgery and pathology underwent conventional MRI and diffusion-weighted imaging (DWI). The MRI features of the tumors, including laterality, size, shape, configuration, signal intensity, ADC value of solid component, enhancement, ascites, synchronous primary cancer (SPC) of the ovary and endometrium, and clinical stage, were evaluated and compared between two groups.
The following characteristics were significantly more common for OECs than HGSCs: unilateral (91.3% vs 50.5%, P < 0.001), larger mass (80.0% vs 48.2%, P = 0.005), round or oval shape (64.0% vs 17.3%, P < 0.001), mainly cystic with mural nodules or papillary projections (72.0% vs 18.7%, P < 0.001), cystic component with homogeneous iso- or hyperintensity on T1WI (82.6% vs 4.3%, P < 0.001), moderate enhancement (52.0% vs 26.6%, P = 0.011), no or mild ascites (91.3% vs 57.0%, P = 0.002), and SPC (43.5% vs 4.3%, P < 0.001). The ADC value of the solid component was higher in OECs (0.979 ± 0.197 × 10(-3) mm(2)/s) than in HGSCs (0.820 ± 0.112 × 10(-3) mm(2)/s) (P = 0.002). When a mainly cystic mass with mural nodules or papillary projections was associated with any one of homogeneously iso- or hyperintense cystic component on TIWI, a relatively higher ADC value and SPC, the sensitivity, specificity, accuracy, and positive and negative predictive values for characterizing OEC were 87.0%, 93.5%, 92.2%, 76.9%, and 96.7%, respectively.
Conventional MRI combining DWI is helpful for differentiating OECs from HGSCs.
探讨磁共振成像（MRI）特征在鉴别卵巢子宫内膜样腺癌（OEC）与高级别浆液性癌（HGSC）中的应用。
23例患有25个OEC的患者以及93例患有139个HGSC的患者，均经手术及病理证实，接受了常规MRI及扩散加权成像（DWI）检查。评估并比较两组肿瘤的MRI特征，包括肿瘤的位置、大小、形状、形态、信号强度、实性成分的表观扩散系数（ADC）值、强化情况、腹水、卵巢及子宫内膜同步原发癌（SPC）以及临床分期。
OEC较HGSC具有以下更常见的特征：单侧性（91.3%对50.5%，P＜0.001）、肿块较大（80.0%对48.2%，P = 0.005）、圆形或椭圆形（64.0%对17.3%，P＜0.001）、主要为伴有壁结节或乳头状突起的囊性（72.0%对18.7%，P＜0.001）、T1加权像（T1WI）上囊性成分呈均匀等或高信号（82.6%对4.3%，P＜0.001）、中度强化（52.0%对26.6%，P = 0.011）、无腹水或轻度腹水（91.3%对57.0%，P = 0.002）以及SPC（43.5%对4.3%，P＜0.001）。OEC实性成分的ADC值（0.979±0.197×10⁻³mm²/s）高于HGSC（0.820±0.112×10⁻³mm²/s）（P = 0.002）。当主要为伴有壁结节或乳头状突起的囊性肿块，同时伴有T1WI上均匀等或高信号的囊性成分、相对较高的ADC值以及SPC中的任何一项时，诊断OEC的敏感度、特异度、准确度、阳性预测值及阴性预测值分别为87.0%、93.5%、92.2%、76.9%及96.7%。
常规MRI联合DWI有助于鉴别OEC与HGSC。
