卵巢囊腺瘤的MR成像价值探讨

摘要

目的:探讨卵巢囊腺瘤的MRI特征,提高对其诊断及鉴别诊断能力,为临床手术前评估及预后判断提供指导.方法:回顾分析46例接受腹、盆腔MRI检查并经手术病理证实的卵巢囊腺瘤患者,分析其MRI常规影像及扩散加权成像特征.结果:46例中浆液性囊腺瘤26例(56.5％),黏液性囊腺瘤20例(43.5％).良性浆液性囊腺瘤,表现为单囊、壁薄、信号均匀,DWI为均匀低信号；交界性浆液性囊腺瘤,表现为多囊,T1WI为均匀低信号,T2wI信号不均匀,呈较高混杂信号,DWI细胞增生活跃区域呈较高信号；恶性浆液性囊腺瘤,表现为多囊多房,壁不均匀增厚,实性结节DWI呈高信号.黏液性囊腺瘤,表现为多房,各囊信号不均,T1WI及T2WI上囊液的信号皆高于浆液性囊腺瘤组;良性黏液性囊腺瘤,多囊、壁薄,DWI囊液表现较高信号;交界性黏液性囊腺瘤壁厚薄不均,交界性瘤灶区域DWI呈高信号,但相对信号较恶性低；恶性黏液性囊腺瘤病灶信号更显混杂,多囊改变更明显,囊壁厚薄不一,见盆腔及腹腔种植转移及肿大淋巴结,DWI信号混杂,高信号多见.结论:DWI在卵巢良恶性肿瘤鉴别方面有一定优势,DWI结合常规MRI影像可对多数卵巢囊腺瘤作出定性诊断.%Objective To explore the characteristics of ovarian cystadenoma in MRI,improve its diagnosis and differential diagnosis,and provide guidance for clinical pre-operative assessment and prognosis.Methods Totally 46 patients with ovarian cystadenoma confirmed by pathology were collected retrospectively.All patients underwent plain whole abdominal or pelvic MRI.Clinical features and MRI characteristics of ovarian cystadenoma were analyzed.Results Of the 46 cases,26(56.5％) of them were serous cystadenoma and 20 (43.5％) were mucinous cystadenoma.Benign serous cystadenoma showed a single capsule,thin wall and uniform signals; borderline serous cystadenoma generally were polycystic and the signal intensity in T1WI was low and uniform but T2WI showed the irregular signals,in some lesions DWI showed a high signals that reflected the cell proliferation was active in this area; malignant serous cystadenoma had the performances of polycystic multilocular,uneven thickening wall and solid nodules DWI showed high signals.Mucinous cystadenoma generally had multilocular cysts and showed irregular signals,and the signals were higher than those of the serous cystadenoma group;benign mucinous cystadenoma usually was polycystic and thin-wall,and the cyst fluid showed a higher signal in DWI;borderline mucinous cystadenoma had a uneven wall and in junctional region of tumor foci DWI showed high signal while lower to the malignant lesions; malignant mucinous cystadenoma lesions showed the signals mixed,polycystic change was obvious,wall thickness was variable,and the pelvic and abdominal metastasis and lymph nodes was existed.Conclusion DWI has certain advantages to identify benign and malignant ovarian tumors,and DWI combined with conventional MRI can make a diagnosis for the majority of ovarian cystadenoma.