Kaga Tetsuro, Kato Hiroki, Hatano Yuichiro, Kawaguchi Masaya, Furui Tatsuro, Morishige Ken-Ichirou, Matsuo Masayuki
Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
Eur J Radiol. 2020 Nov;132:109281. doi: 10.1016/j.ejrad.2020.109281. Epub 2020 Sep 12.
Our purpose was to determine if MRI could be used to distinguish ovarian mucinous carcinoma (MC) from mucinous borderline tumor (MBT).
This study included 63 consecutive patients with histopathologically proven ovarian mucinous neoplasms (11 MCs and 52 MBTs) who underwent preoperative contrast-enhanced MRI. MRI images were retrospectively reviewed and compared between the 2 pathologies.
The maximum tumor diameters (219.7 ± 80.8 mm vs. 177.4 ± 56.5 mm, p < 0.05) and maximum mural nodule (MN) diameters (41.7 ± 33.8 mm vs. 6.6 ± 8.9 mm, p < 0.01) were significantly larger in MCs than in MBTs. MNs larger than 5 mm (82 % vs. 29 %, p < 0.01) and abnormal ascites (45 % vs. 12 %, p < 0.05) were significantly more frequent in MCs than in MBTs. Apparent diffusion coefficient (ADC) values of MN were significantly lower in MCs than in MBTs (1.20 ± 0.25 × 10 mm/s vs. 1.61 ± 0.35 × 10 mm/s, p < 0.05). No significant difference was found in number of loculi, honeycomb sign, stained glass appearance, fluid-fluid level, thickened septa larger than 5 mm, peritoneal dissemination, or T2 hypointense microcysts between MCs and MBTs. T2 hypointense microcysts were observed only in 7 MBTs (13%).
MRI findings of these 2 pathologies overlapped considerably. Compared with MBTs, MCs exhibited larger tumor size, larger MN size, and lower ADC values of MN, and MCs more frequently had MNs larger than 5 mm and abnormal ascites. T2 hypointense microcysts might be a specific MRI finding in MBTs.
我们的目的是确定磁共振成像（MRI）是否可用于区分卵巢黏液性癌（MC）和黏液性交界性肿瘤（MBT）。
本研究纳入了63例经组织病理学证实的卵巢黏液性肿瘤患者（11例MC和52例MBT），这些患者均接受了术前对比增强MRI检查。对MRI图像进行回顾性分析，并比较两种病理类型之间的差异。
MC的最大肿瘤直径（219.7±80.8mm对177.4±56.5mm，p<0.05）和最大壁结节（MN）直径（41.7±33.8mm对6.6±8.9mm，p<0.01）显著大于MBT。直径大于5mm的MN（82%对29%，p<0.01）和异常腹水（45%对12%，p<0.05）在MC中比在MBT中更常见。MC中MN的表观扩散系数（ADC）值显著低于MBT（1.20±0.25×10⁻³mm²/s对1.61±0.35×10⁻³mm²/s，p<0.05）。在小房数量、蜂窝征、玻璃样外观、液-液平面、大于5mm的增厚间隔、腹膜播散或T2低信号微囊肿方面，MC和MBT之间未发现显著差异。仅在7例MBT（13%）中观察到T2低信号微囊肿。
这两种病理类型的MRI表现有相当大的重叠。与MBT相比，MC表现为更大的肿瘤大小、更大的MN大小和更低的MN的ADC值，且MC中直径大于5mm的MN和异常腹水更常见。T2低信号微囊肿可能是MBT的特异性MRI表现。
