卵巢癌的磁共振动态增强诊断

目的探讨1.5T磁共振（MRI）动态增强在卵巢癌诊断中的临床应用价值。材料和方法回顾性分析经病理证实的38例卵巢癌动态增强MRI资料,其中27例经手术病理证实,11例经超声引导穿刺活检证实。所有病例均行1.5T磁共振T1加权成像（T1WI）、T2加权成像（T2WI）、扩散加权成像（DWI）及动态增强磁共振成像（DCE MRI）。结果浆液性囊腺癌3例病灶表现为囊性肿块,12例表现为囊实性肿块,3例表现为实性肿块。MRI平扫表现：T1WI呈低信号或稍低、等信号,T2WI呈高、略高信号,信号不均匀,DWI呈不均匀高信号。动态增强扫描表现为厚薄不均的囊壁及实性部分明显强化。粘液性囊腺癌8例病灶为囊实性肿块,6例表现为实性肿块。MRI平扫表现：T1WI、T2WI信号不均匀,呈混杂信号,DWI呈不均匀高信号,病灶内可有出血。动态增强扫描：囊壁、囊内片状阴影、间隔以及结节较明显强化,实性部分强化明显。未分类的囊腺癌3例病灶表现为囊实性肿块,3例表现为实性肿块;平扫及动态增强表现与粘液性囊腺癌相似。结论 1.5T磁共振动态增强对卵巢癌的诊断具有很高的临床应用价值。

Application of Dynamic Contrast Enhanced Magnetic Resonance Imaging in the Diagnosis of Ovarian Carcinoma

Objective To discuss the diagnostic accuracy and clinical value of 1.5T dynamic contrast enhanced magnetic resonance imaging in the diagnosis of ovarian carcinoma. Materials and Methods The MRI data of 38 pathologically proved ovarian carcinoma cases were analyzed. 27 cases were confirmed by operation and pathology; 11 cases were confirmed by ultrasonically guided biopsy. All the cases were performed with T1 WI, T2 WI, diffusion weighted imaging（DWI） and dynamic contrast enhanced magnetic resonance imaging（DCE-MRI）. Results 3 cases with serous cystadenocarcinoma were cystic masses. 12 cases showed cystic-solid mixed masses. 3 cases showed solid masses. MRI plain scanning： Focuses showed low signal,slightly low signal or equisignal on T1 WI, and showed high or slightly high signal on T2 WI. The signal was not uniform. Focuses showed high signal on DWI. DCE-MRI： cyst wall showed not enhancement and solid mass showed obviously enhancement. 8 cases with mucous cystoadenocarcinoma were cystic-solid mixed masses, and 6 cases showed solid masses. MRI plain scanning： Focuses showed heterogeneous signal on T1 WI and T2 WI, and heterogeneous high signal on DWI. DCE-MRI： cyst wall and interval showed heterogeneous enhancement. The solid mass showed obviously enhancement. 3 cases with unclassified cystadenocarcinoma showed cystic-solid mixed masses, and 3 cases showed solid masses. Plain scanning and dynamic contrast enhancement showed similar with mucous cystoadenocarcinoma. Conclusion 1.5T dynamic contrast enhanced magnetic resonance imaging has important value in the diagnosis of ovarian carcinoma.