3.0TMRI对附件囊实性病变的诊断价值及误诊原因分析

摘要

AbstractObjective:To discuss the value of 3.0 tesila MRI in the diagnosis of cystic-solid masses of appendix. And, to analyse the causes of misdiagnosis of common accessories lesions like mature ovarian cystic teratoma, endometrisis cysts, cystadenoma, borderline cystadenoma and ovarian canner.Materials and Methods:A total of 125 lesions were collected in this study, all lesions were diagnosed as cystic-solid masses of appendix by postoperative pathology. The MRI manifestations were analyzed retrospectively, and the causes of misdiagnosis were summarized.Results:There were 84 benign lesions, 25 borderline lesions, and 16 maglignant lesions. Among all of the lesions, there were 104 lesions (83.2%) were diagnosed accurately by MRI, 21 lesions (16.8%) were misdiagnosed. Thirteen in 16 maglignant lesions of MRI staging were coincide well with pathological staging, however, 3 lesions of MRI staging was lighter than pathological staging. The ADC value was statistically significant among benign (1.325×10-3 mm/s), borderline (1.081×10-3 mm/s) and malignant lesions (0.928×10-3 mm/s) groups (P<0.05).Conclusions:Although benign and malignant (especially the borderline) cystic-solid lesions of appendix on MRI have certain overlap, the diagnostive value for cystic-solid masses of appendix on 3.0 tesila MR was high. Some of the cystic-solid lesions have particular characteristics in MR imagings. To analyse and summarize the reasons for misdiagnosed cases could be useful for improving the accuracy of diagnosis.%目的：分析3.0 T MRI对附件囊实性占位性病变的诊断价值，分析囊性成熟型畸胎瘤、子宫内膜异位囊肿、囊腺瘤、交界性囊腺瘤及卵巢癌等常见附件病变误诊的原因。材料与方法搜集125例经术后病理证实的盆腔附件区囊实性病变，对MRI征象进行回顾性分析，并总结造成误诊的原因。结果良性病变84例，交界性病变25例，恶性病变16例。MRI定性准确104例(83.2%)，21例误诊(16.8%)。16例恶性病变中13例的MRI分期与病理分期相符，3例MRI分期较病理分期偏轻。良性、交界性及恶性病变的平均ADC值分别为1.325×10-3 mm/s、1.081×10-3 mm/s、0.928×10-3mm/s，两两之间的差异均具有统计学意义(P＜0.05)。结论尽管附件良性和恶性(特别是交界性)囊实性病变在MRI表现上有一定的重叠，但总体来说3.0 T MRI对附件囊实性占位性病变有较高的诊断价值。部分病变在MRI上有一定的特征性表现。对误诊病例的分析和总结有助于提高诊断的准确性。