磁共振成像在小儿良性卵巢病变诊断与管理中的应用

The utility of magnetic resonance imaging in the diagnosis and management of pediatric benign ovarian lesions.

作者信息

Emil Sherif, Youssef Fouad, Arbash Ghaidaa, Baird Robert, Laberge Jean-Martin, Puligandla Pramod, Albuquerque Pedro

机构信息

Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada.

出版信息

J Pediatr Surg. 2018 Oct;53(10):2013-2018. doi: 10.1016/j.jpedsurg.2017.12.028. Epub 2018 Jan 31.

DOI:10.1016/j.jpedsurg.2017.12.028

PMID:29433795

Abstract

BACKGROUND

The utility of magnetic resonance imaging (MRI) in the diagnosis and management of pediatric ovarian lesions has not been well defined.

METHODS

A retrospective review of all girls who underwent MRI evaluation of ovarian masses during the period 2009-2015 was performed. The accuracy of MRI was evaluated by comparing results with surgical findings, pathology reports, and subsequent imaging. The influence of the MRI on the treatment plan was specifically explored.

RESULTS

Eighteen girls, 12-17years of age, underwent 27 MRIs, subsequent to ultrasound identification of ovarian lesions. Of 9 neoplastic lesions diagnosed on MRI, 8 (89%) were confirmed by surgical and pathological findings. Of 18 functional lesions, 17 (94.4%) were confirmed pathologically or by resolution on subsequent imaging. Twenty MRI exams (74%) directly influenced the treatment plan, by leading to appropriate operative intervention in 9 and appropriate observation in 11. The extent of ovarian resection was guided by MRI findings in 8 of 9 (89%) neoplastic lesions. For characterizing lesions as neoplastic, the sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MRI were 89%, 94%, 94%, 89%, and 93% respectively.

CONCLUSIONS

MRI can differentiate functional from neoplastic pediatric ovarian masses, and guide ovarian resection in appropriate cases.

LEVEL OF STUDY

II.

摘要

背景

磁共振成像（MRI）在小儿卵巢病变诊断及处理中的应用尚未明确。

方法

对2009年至2015年期间接受卵巢肿块MRI评估的所有女孩进行回顾性研究。通过将MRI结果与手术所见、病理报告及后续影像学检查结果进行比较，评估MRI的准确性。特别探讨了MRI对治疗方案的影响。

结果

18名年龄在12至17岁的女孩在超声发现卵巢病变后接受了27次MRI检查。MRI诊断的9例肿瘤性病变中，8例（89%）经手术和病理检查证实。18例功能性病变中，17例（94.4%）经病理检查或后续影像学检查病变消退得以证实。20次MRI检查（74%）直接影响了治疗方案，其中9例促成了适当的手术干预，11例促成了适当的观察。9例肿瘤性病变中有8例（89%）的卵巢切除范围由MRI检查结果指导。对于将病变判定为肿瘤性病变，MRI的敏感性、特异性、阴性预测值、阳性预测值及准确性分别为89%、94%、94%、89%和93%。