Takai Yukiko, Kato Hiroki, Kawaguchi Masaya, Kobayashi Kazuhiro, Kikuno Kyoko, Furui Tatsuro, Isobe Masanori, Noda Yoshifumi, Hyodo Fuminori, Matsuo Masayuki
Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
Department of Pathology, Gifu University, Gifu, Japan.
Jpn J Radiol. 2025 Apr;43(4):676-686. doi: 10.1007/s11604-024-01700-6. Epub 2024 Nov 14.
To evaluate the efficacy of MRI findings for differentiating between ovarian metastasis from stomach cancer (OMSC) and colorectal cancer (OMCC).
Twenty-six patients with histopathologically proven ovarian metastasis (n = 8 with 12 OMSCs and n = 18 with 25 OMCCs) were enrolled in the study. All patients had undergone pelvic MRI before surgery. We retrospectively reviewed MRI findings and compared them between the two pathologies. The black scrunchie sign was defined as a thick (> 5 mm) and lobulated hypointense rim (> 180°) with central hyperintense areas on T2-weighted images.
Predominantly solid lesions (100% vs. 20%, p < 0.01), black scrunchie sign (33% vs. 0%, p < 0.01), and flow void (67% vs. 20%, p < 0.01) were frequently observed in OMSCs than in OMCCs. The signal intensity ratio of solid components on T2-weighted images (3.30 ± 0.70 vs. 2.52 ± 0.77, p < 0.01) and gadolinium-enhanced T1-weighted images (2.21 ± 0.57 vs. 1.43 ± 0.32, p < 0.01) were significantly higher in OMSCs than in OMCCs. Furthermore, hyperintense areas within cystic components on T1-weighted images (71% vs. 18%, p < 0.01) and stained-glass appearance (44% vs. 0%, p < 0.01) were frequently observed in OMCCs than in OMSCs.
The black scrunchie sign was only observed in OMSCs. OMSCs always exhibited predominantly solid lesions and had higher signal intensity of solid components on T2- and gadolinium-enhanced T1-weighted images. OMCCs usually presented as cystic lesions, usually accompanied by hyperintense areas within the cystic components on T1-weighted images.
评估磁共振成像（MRI）表现对鉴别胃癌卵巢转移（OMSC）和结直肠癌卵巢转移（OMCC）的有效性。
26例经组织病理学证实为卵巢转移的患者纳入研究（8例患者有12个OMSC，18例患者有25个OMCC）。所有患者在手术前均接受了盆腔MRI检查。我们回顾性分析了MRI表现，并对两种病理类型的表现进行了比较。黑色发圈征定义为在T2加权图像上有增厚（>5mm）且呈分叶状的低信号边缘（>180°），中央为高信号区。
与OMCC相比，OMSC中更常出现实性为主的病变（100%对20%，p<0.01）、黑色发圈征（33%对0%，p<0.01）和流空现象（67%对20%，p<0.01）。在T2加权图像上实性成分的信号强度比（3.30±0.70对2.52±0.77，p<0.01）以及钆增强T1加权图像上实性成分的信号强度比（2.21±0.57对1.43±0.32，p<0.01）在OMSC中显著高于OMCC。此外，与OMSC相比，OMCC在T1加权图像上囊性成分内的高信号区（71%对18%，p<0.01）和玻璃样外观（44%对0%，p<0.01）更常见。
黑色发圈征仅在OMSC中观察到。OMSC总是以实性为主的病变表现，且在T2加权和钆增强T1加权图像上实性成分具有更高的信号强度。OMCC通常表现为囊性病变，通常在T1加权图像上囊性成分内伴有高信号区。
