Li Hai Ming, Qiang Jin Wei, Xia Gan Lin, Zhao Shu Hui, Ma Feng Hua, Cai Song Qi, Feng Feng, Fu Ai Yan
From the *Department of Radiology, Jinshan Hospital and Shanghai School of Medicine, Fudan University, Shanghai; †Department of Radiology, Nantong Cancer Hospital, Nantong, Jiangsu; and ‡Department of Radiology, Xinhua Hospital and Shanghai School of Medicine, Jiao Tong University, Shanghai, China.
J Comput Assist Tomogr. 2015 May-Jun;39(3):401-5. doi: 10.1097/RCT.0000000000000210.
This study aimed to investigate the magnetic resonance imaging (MRI) features of ovarian endometrioid adenocarcinoma (OEC) and to evaluate conventional MRI and diffusion-weighted imaging (DWI) for diagnosing OEC.
Twenty patients with OEC proven by surgery and pathology underwent MRI. The MRI features of the tumors evaluated included laterality, shape, size, configuration, mural nodules, signal intensity, apparent diffusion coefficient (ADC) values, enhancement, peritoneal implants, ascites, and synchronous primary cancer (SPC) of the ovary and endometrium.
Unilateral ovarian masses were observed in 18 (90%) of the 20 patients with 22 OEC lesions, whereas the remaining 2 (10%) patients had bilateral masses. Oval, lobulated, and irregular shapes were observed in 13 (59%), 6 (27%), and 3 (14%) tumors, respectively. The maximum diameter of the tumors ranged from 3.7 to 22.5 cm, with a mean of 11.2 ± 5.1 cm. Fifteen (68%) masses were mainly cystic with mural nodules, 5 (23%) were mixed cystic-solid, and 2 (9%) were solid. The solid components of tumors showed isointensity (100%) on T1-weighted imaging (T1WI), heterogeneous hyperintensity on T2-weighted imaging (T2WI) (86%), and hyperintensity on DWI (82%), with a mean ADC value of (0.96 ± 0.20) × 10 mm/s. The cystic components showed isointensity or hyperintensity (85%) on T1WI, hyperintensity on T2WI (100%), and hypointensity on DWI (63%), with a mean ADC value of (2.27 ± 0.27) × 10 mm/s. Ten (50%) of the patients were SPC. The mean ADC values of the solid components were (0.85 ± 0.19) × 10 mm/s and (1.08 ± 0.15) × 10 mm/s in only-OEC and SPC, respectively, with a statistically significant difference (P = 0.012).
Ovarian endometrioid adenocarcinoma usually appears as a large, oval, or lobulated cystic mass with mural nodules. Cystic components show isointensity or hyperintensity on T1WI, solid components and hyperintensity on T2WI and DWI. Synchronous primary cancer of the ovary endometrium is another characteristic feature of OEC.
本研究旨在探讨卵巢子宫内膜样腺癌（OEC）的磁共振成像（MRI）特征，并评估传统MRI和扩散加权成像（DWI）在诊断OEC中的作用。
20例经手术及病理证实为OEC的患者接受了MRI检查。评估的肿瘤MRI特征包括位置、形状、大小、形态、壁结节、信号强度、表观扩散系数（ADC）值、强化情况、腹膜种植、腹水以及卵巢和子宫内膜的同步原发性癌（SPC）。
20例患有22个OEC病灶的患者中，18例（90%）观察到单侧卵巢肿块，其余2例（10%）为双侧肿块。分别有13个（59%）、6个（27%）和3个（14%）肿瘤呈椭圆形、分叶状和不规则形。肿瘤最大直径范围为3.7至22.5 cm，平均为11.2±5.1 cm。15个（68%）肿块主要为囊性伴壁结节，5个（23%）为囊实性混合，2个（9%）为实性。肿瘤实性成分在T1加权成像（T1WI）上呈等信号（100%），在T2加权成像（T2WI）上呈不均匀高信号（86%），在DWI上呈高信号（82%），平均ADC值为（0.96±0.20）×10⁻³mm²/s。囊性成分在T1WI上呈等信号或高信号（85%），在T2WI上呈高信号（100%），在DWI上呈低信号（63%），平均ADC值为（2.27±0.27）×10⁻³mm²/s。10例（50%）患者为SPC。仅OEC组和SPC组实性成分的平均ADC值分别为（0.85±0.19）×10⁻³mm²/s和（1.08±0.15）×10⁻³mm²/s，差异有统计学意义（P = 0.012）。
卵巢子宫内膜样腺癌通常表现为较大的椭圆形或分叶状囊性肿块伴壁结节。囊性成分在T1WI上呈等信号或高信号，实性成分在T2WI和DWI上呈高信号。卵巢子宫内膜同步原发性癌是OEC的另一个特征性表现。
