磁共振成像诊断卵巢转移瘤的价值

目的：对比分析卵巢转移瘤与原发性卵巢癌的磁共振成像（MRI）征象,探讨MRI诊断卵巢转移瘤的价值.材料和方法：回顾性分析经手术和病理证实的25例卵巢转移瘤的MRI表现,同期59例原发性卵巢癌作为对照.比较两组肿瘤的分布、边缘、大小、形态、囊/实性、分房、壁结节或乳头状突起、信号、强化程度、腹膜种植灶、转移等征象的差异.结果：25例卵巢转移瘤MRI共发现41个卵巢肿块,16例（64.0％）累及双侧卵巢;59例原发性卵巢癌MRI共发现84个卵巢肿块,25例（42.4％）累及双侧卵巢,双侧卵巢发生率在两组间差异无统计学意义（P=-0.070）.光滑的边缘、分叶形肿块、T1WI抑脂不均匀等和低信号、实性成分T2WI等信号及实性成分内边界清晰的囊肿样信号5个征象在转移瘤中（29/41、21/41、29/41、10/38、15/28）较原发性癌多见（26/84、27/84、39/84、6/84、6/65）（P值分别为0.000、0.040、0.010,0.004、0.000）;不规则形肿块、囊壁结节或乳头状突起、T1WI抑脂含高信号及实性区T2WI高信号4个征象在原发性癌中（35/84、16/19、30/84、78/84）较转移瘤多见（5/41、6/13、6/41、28/38）（P值分别为0.001、0.049、0.015、0.004）.结论：MRI可显示卵巢转移瘤与原发性卵巢癌不同的MRI表现,有助于两者的鉴别.

The value of MRI in the diagnosis of metastatic ovarian tumors

Objective： To investigate magnetic resonance imaging （MRI） features in differentiating metastatic ovarian tumors and primary ovarian carcinomas. Materials and Methods： Twenty five patients with secondary metastatic ovarian carcinomas and 59 patients with primary ovarian carcinomas proven by surgery and pathology underwent MRI. MRI features of the two groups of tumors were evaluated and compared including laterality, size, margin, shape, cystic/solid, loculation, mural nodules or papillary projections, signal intensity, enhancement, peritoneal implants and metastasis of lymph node or distant organ. Re- stilts： On MRI, bilateral ovarian masses were seen in 16 （64%） of 25 patients with 41 secondary ovarian tumors, whereas 25 （42.4%） of 59 primary ovarian carcinomas with 84 ovarian tumors showed this feature. The difference of laterality was not sta- tistically significant（P=-0.070）. A smooth margin, lobulated shape, intermediate and low signal intensity on TIWI fat suppression, intermediate signal intensity on T2WI in solid components and well demarcated intratumoral cystic lesions within solid portion of the tumor were significantly more common in secondary tumors（29/41, 21/41, 29/41, 10/38, 15/28, respectively） than in pri- mary ovarian carcinomas（26/84, 27/84, 39/84, 6/84, 6/65, respectively）（P=-0.000, 0.040, 0.010, 0.004, 0.000, respectively）. Irreg- ular shape, mural nodules or papillary projections, intratumoral hyperintense portion on 1WI fat suppression and hyperintense solid components on T2WI were significantly more common in the primary（35/84, 16/19, 30/84, 78/84, respectively） than in the secondary ovarian carcinomas （5/41, 6/13, 6/41, 28/38, respectively）（P=0.001, 0.049, 0.015, 0.004, respectively）. Conclusion： MRI can demonstrate the different morphological features between secondary and primary ovarian carcinomas which is helpful for discriminating the two groups.