Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine.
Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine.
Magn Reson Med Sci. 2018 Jul 10;17(3):211-217. doi: 10.2463/mrms.mp.2017-0055. Epub 2017 Oct 6.
Seromucinous borderline tumor (SMBT) is a newly categorized ovarian tumor in the 2014 revised World Health Organization (WHO) classification. SMBT is similar to serous borderline tumor (SBT) on MRI reflecting their pathological findings. This study was conducted to demonstrate the usefulness of MRI findings and quantitative values for differentiating SMBT from SBT.
This retrospective study examined 23 lesions (20 patients) from SMBT and 26 lesions (22 patients) from SBT. The following quantitative values were evaluated using receiver-operating characteristics analysis: overall and solid portion sizes, intracystic fluid signal intensity (SI) ratio compared with skeletal muscle on Tweighted image (TWI) and Tweighted image (TWI), contrast enhancement (CE) ratio, and mean and minimum apparent diffusion coefficient values of the solid portion. Two radiologists evaluated the prevalence of MRI finding characteristics of SMBT and SBT. The SI of the intracystic fluid on TWI and TWI and the association with endometriosis were evaluated visually.
The CE ratio was significantly higher in SBT (P = 0.007). It achieved the highest area under the curve (AUC) (0.739). The fluid SI ratio on TWI was higher in SMBT (P = 0.036, AUC = 0.676). Exophytic growth of the solid portion was observed only in SBT (P = 0.011). Intracystic fluid SI of SMBT was higher on TWI and lower on TWI in visual evaluation (P = 0.008 and 0.007, respectively). Findings suggesting endometriosis were observed more frequently in SMBT patients (P = 0.019).
Higher CE ratio of the solid portion and exophytic growth were findings suggesting SBT. Higher intracystic fluid SI on TWI and lower SI on TWI suggested SMBT. MRI findings suggesting endometriosis favored the diagnosis of SMBT.
黏液性交界性肿瘤（SMBT）是 2014 年世界卫生组织（WHO）修订分类中新分类的卵巢肿瘤。SMBT 在 MRI 上类似于浆液性交界性肿瘤（SBT），反映了其病理发现。本研究旨在证明 MRI 发现和定量值在区分 SMBT 和 SBT 中的有用性。
本回顾性研究共检查了 23 例 SMBT 病变（20 例患者）和 26 例 SBT 病变（22 例患者）。使用受试者工作特征分析评估以下定量值：总体和实性部分大小、TWI 和 TWI 上与骨骼肌相比的囊内液体信号强度（SI）比值、对比增强（CE）比值以及实性部分的平均和最小表观扩散系数值。两位放射科医生评估了 SMBT 和 SBT 的 MRI 表现特征的发生率。通过视觉评估评估 TWI 和 TWI 上囊内液体的 SI 与子宫内膜异位症的关系。
SBT 的 CE 比值明显更高（P = 0.007）。它获得了最高的曲线下面积（AUC）（0.739）。SMBT 的 TWI 上囊内液体 SI 较高（P = 0.036，AUC = 0.676）。实性部分的外生性生长仅见于 SBT（P = 0.011）。SMBT 的囊内液体 SI 在 TWI 上较高，在 TWI 上较低（P = 0.008 和 0.007）。视觉评估显示，SMBT 患者中发现提示子宫内膜异位症的表现更频繁（P = 0.019）。
实性部分的 CE 比值较高和外生性生长提示 SBT。TWI 上囊内液体 SI 较高和 TWI 上 SI 较低提示 SMBT。MRI 发现提示子宫内膜异位症有助于 SMBT 的诊断。
