女性盆腔肿块的MRI诊断与鉴别诊断

目的:探讨MRI在女性盆腔肿块中的诊断与鉴别诊断价值。方法:回顾性分析139个(75例)经术后病理证实的盆腔肿块的MRI征象。结果:MRI检出病灶共129个(129/139,92.8%),其中子宫病变67个(67/69,97.1%),卵巢病变62个(62/70,88.6%),2个子宫肌瘤、5个卵巢冠囊肿、3个黄体囊肿漏诊(10/139,7.2%)。MRI检出的129个病灶中,128个病灶部位均符合手术所见,准确性为99.2%。子宫病变主要表现为实质性肿块影或子宫内膜增厚;卵巢病变表现为囊性、囊实性或实性肿块影。MRI诊断为良性病变108个,恶性病变21个;病理诊断为良性病变116个,恶性病变23个,MRI诊断出恶性病变的灵敏度为91.3%(21/23),阳性预测值为100%。结论:MRI判断盆腔病灶的起源具有很高的准确性,在判断良恶性肿瘤方面亦具有较高的准确性,但是区分恶性肿瘤的细胞类型难度较大。

MRI diagnosis and differential diagnosis of female pelvic masses

Objective:To explore the value of MRI in diagnosis and differential diagnosis of female pelvic masses.Methods:Reviewed the characterizations of MRI in 139 female pelvic masses(75 patients)proved by pathology.Results: Total 129 masses(129/139,92.8%) were detected by MRI,including uterus masses(67/69,97.1%),ovarian masses(62/70,88.6%),but MRI didn't detect 2 leiomyomas,5 parovarian cystis and 3 corpus luteum cystis.In 129 masses,for the location,the accuracy was 99.2%(128/129).Uterus diseases mainly performed solid masses or endometrial thickening,ovarian diseases mainly performed cystic or cystic-solid or solid masses. In MRI,benign lesions were 108,malignant lesions were 21,while in the pathologic findings,benign lesions were 116,malignant lesions were 23,the sensitivity of MRI in the diagnosis malignant lesions was 91.3%(21/23),and the postitive predictive value was 100%.Conclusion:MRI judged the origin of pelvic lesions with high accuracy as well as distinction between benign and malignant lesions,but there was some difficult to diagnose cell types.