超声与MRI在筛查及鉴别卵巢肿瘤良恶性病变中应用研究

目的探讨超声与MRI在筛查及鉴别卵巢肿瘤良恶性病变中的应用价值。方法选取经手术和病理证实的卵巢肿瘤病变患者80例,术前行超声、MRI检查,将检查诊断结果与手术病理结果相比较,分析超声、MRI鉴别卵巢肿瘤良恶性病变的准确性,并分析二者的影像学表现。结果 MRI术前定性诊断准确率90.00%与良、恶性诊断准确率96.08%、93.55%均略高于超声诊断,但二者差异无统计学意义(P0.05)。超声图像显示良性肿瘤边界清楚,内部血管稀疏、分支简单、走行规则,血管光滑,数目无明显增多;恶性肿瘤边界模糊不清,瘤体内血管丰富,分支紊乱,走行不规则,呈繁星状、团簇状,数目明显增多,迂曲明显。MRI图像显示良性肿瘤多为单发,以囊性为主,囊壁薄,厚薄均匀,信号多均匀强化,仅部分邻近组织受侵,T1WI低信号,T2WI高信号,增强扫描无明显强化;恶性肿瘤多发于双侧卵巢,以囊实性和实性为主,囊壁厚,囊内分隔厚薄不均,盆壁、腹膜、腹水、盆腔淋巴结肿大,T1WI等低混杂信号,T2WI混杂稍高信号,环形或不均匀强化。结论超声与MRI的卵巢肿瘤影像学表现特征明显,在筛查及鉴别卵巢肿瘤良恶性病变时可互为补充,提高临床诊断准确率。

Application of Ultrasound and MRI in Screening and Differentiation of Benign and Malignant Ovarian Tumors

Objective To investigate the value of ultrasound and MRI in the diagnosis and differentiation of benign and malignant ovarian tumors.Methods Eighty patients with ovarian cancer confirmed by operation and pathology were studied.All patients underwent ultrasound and MRI examination before operation.The diagnostic results were compared with the results of operation and pathology.The accuracy rates of ultrasound and MRI in differentiating benign and malignant ovarian tumors were analyzed,and the imaging findings of the two were also analyzed.Results The accuracy rate of preoperative qualitative diagnosis,and accuracy rates in diagnosis of benign and malignant ovarian tumors of MRI (90.00％,96.08％,93.55％) were slightly higher than those of ultrasound (P＞0.05).Ultrasonic images showed that the boundaries of benign tumors were clear,the internal blood vessels were sparse,the branches were simple,the run was regular,blood vessels were smooth and the number was not significantly increased;the boundaries of malignant tumors were blurred,intratunoral blood vessels were rich,branches were in disorder,the run was irregularand was in stars form or cluster form,the number was increased significantly,and tortuosity was obvious.MRI image showed that benign tumors were solitary,the majority were cystic,cystic wall was thin and homogenous,most signals were homogenously enhanced,only part of the adjacent tissues were invaded,there was low signal on T1WI and high signal on T2WI,but enhanced scan showed no obvious enhancement;most malignant tumors were located in bilateral ovarian,mainly were cystic and solitary,cystic wall is thick,the intracystic compartment was inhomogenous,with pelvic wall,peritoneum,ascites and pelvic lymphadenectasis,there was equal-low signal on T1WI and mixed slightly high signal on T2WI,annular or uneven enhancement.Conclusion The ultrasound and MRI findings of ovarian tumors are obvious,which can complement each other in screening and differentiation of benign and malignant ovarian tumors,and can be used to improve the accuracy of clinical diagnosis.