目的 探讨扩散加权成像及常规MRI在卵巢交界性肿瘤与上皮性卵巢癌中的鉴别诊断价值.方法 回顾性分析我院2012年10月～2017年10月经病理证实卵巢交界性肿瘤与上皮性卵巢癌的MRI影像资料, 分析它们在肿瘤侧别、大小、形状、形态、信号特征、强化程度及DWI信号、ADC值等方面差异, 并比较两者在术前血清CA125水平上的差异.结果 共有交界性肿瘤39例, 41个病灶, 上皮性卵巢癌47例, 51个病灶.交界性肿瘤以未绝经期女性多见, 上皮性卵巢癌主要发生于绝经后女性, 两者在术前血清CA125水平上无明显差异.交界性肿瘤常表现为形态规则、纯囊性, PA&IB结构仅见于交界性肿瘤, 而上皮性卵巢癌以分叶状、实性多见, 上皮性卵巢癌实性成分平均大小大于交界性肿瘤, 腹膜转移更常见于上皮性卵巢癌.DWI高信号更常见于上皮性卵巢癌, 交界性肿瘤ADC平均值高于上皮性卵巢癌, ADC平均值取临界值1.06×10-3mm2/s, 诊断BOTs的敏感性、特异性分别为91.7％、76％.结论 常规MRI辅以扩散加权成像可较好地鉴别卵巢交界性肿瘤与上皮性卵巢癌.%Objective To explore conventional magnetic resonance imaging and diffusion weighted imaging in differentiating ovarian borderline tumors (BOTs) and malignant epithelial tumor (MEOTs). Methods Ovarian tumor involving borderline tumors and malignant epithelial tumors were retrospectively analyzed between October 2012 and October 2017. Imaging data including bilaterality, tumor size, shape, morphology, signal intensity and value of ADC, were analyzed. The preoperative level of CA-125 was also compared. Results There were 39 BOTs patients with 41 tumors and 47 MEOTs patients with 51 tumors. BOTs were commonly seen in premenopausal women while MEOTs occured in postmenopausal women. The preoperative level of CA125 showed no significant difference between BOTs and MEOTs. Round or regular shape, purely cystic features were more commonly seen in BOTs whereas irregular shape, solid features were commonly seen in MEOTs. PA&IB was only seen in BOTs. The diameter of the solid components was larger in MEOTs than BOTs. Peritoneum implants were frequently shown in MEOTs. High signal intensity on DWI was mostly seen in MEOTs, likewisely, the value of ADC was lower in MEOTs than BOTs. With the cut-off value of 1.06×10-3 mm2/s of ADC, the sensitivity and specificity were 91.7％, 76％ respectively for differentiating BOTs from MEOTs. Conclusion Conventional magnetic resonance imaging and DWI are valuable in differentiating BOTs and MEOTs.
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