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磁共振成像(MRI)在卵巢良恶性肿瘤鉴别诊断中的临床评估

Clinical evaluation of MRI in the differential diagnosis between benign and malignant ovarian tumors.

作者信息

Zhang Tao, Yi Xin, Lu Jian, Fu Aiyan

出版信息

Eur J Gynaecol Oncol. 2017;38(2):257-262.

PMID:29953791
Abstract

Ovarian tumors present a special diagnostic challenge when imaging findings cannot be categorized into benign or malignant pathology. Magnetic resonance imaging (MRI) is currently used to evaluate ovarian tumors. The aim of this study was to evaluate the diagnostic performance of MRI in patients with benign or malignant ovarian tumors and enhance its diagnostic accuracy. The MRI findings of 48 cases of ovarian tumors, which were confirmed by surgery or pathology from September 2009 to July 2011, were analyzed ret- rospectively. Ti-, T2-, and fat-suppressed T2-weighted sequences were performed and dynamic contrast-enhanced Tl-weighted gradient-echo images were performed after IV injection of Gd-DTPA by 1.5-T unit. The ovarian tumors were examined for several features including size, bilaterality, shape, content (solid-cystic), signal intensity, and enhancement. Secondary signs such as ascites, peritoneal disease, and lymphadenopathy were noted. The imaging features with the surgical and pathologic findings were compared and the MRI features of benign and malignant ovarian tumors were compared and summarized. MRI features of 33 cases of malignant ovarian tumors were cystic-solid or solid masses, with irregular wall, and intense enhancement. MRI features of 15 cases of benign ovarian tumors were cystic masses, with regular wall, and not or slightly enhanced. The differences of bilaterality, shape, content (solid-cystic), signal intensity, and enhancement between benign and malignant ovarian tumors were statistically significant (p < 0.01). The data demonstrate MRI features may help differentiate benign ovarian tumors from malignant ovarian tumors.

摘要

当影像学检查结果无法归类为良性或恶性病变时,卵巢肿瘤的诊断面临特殊挑战。磁共振成像(MRI)目前用于评估卵巢肿瘤。本研究的目的是评估MRI对良性或恶性卵巢肿瘤患者的诊断性能,并提高其诊断准确性。回顾性分析了2009年9月至2011年7月间48例经手术或病理证实的卵巢肿瘤的MRI表现。采用T1、T2及脂肪抑制T2加权序列,并通过1.5-T设备静脉注射钆喷酸葡胺(Gd-DTPA)后进行动态对比增强T1加权梯度回波成像。对卵巢肿瘤的大小、双侧性、形态、内容物(实性-囊性)、信号强度及强化等特征进行检查。记录腹水、腹膜病变及淋巴结病等间接征象。将影像学特征与手术及病理结果进行比较,并对良性和恶性卵巢肿瘤的MRI特征进行比较和总结。33例恶性卵巢肿瘤的MRI特征为囊实性或实性肿块,壁不规则,强化明显。15例良性卵巢肿瘤的MRI特征为囊性肿块,壁规则,无强化或轻度强化。良性和恶性卵巢肿瘤在双侧性、形态、内容物(实性-囊性)、信号强度及强化方面的差异具有统计学意义(p<0.01)。数据表明,MRI特征有助于鉴别良性和恶性卵巢肿瘤。

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