超声造影、CT、MRI在卵巢肿瘤临床应用比较

目的探讨并对比超声造影、CT、MRI在卵巢肿瘤诊断中的应用价值。方法回顾性分析63例经临床病理确诊的卵巢肿瘤患者的超声造影、CT及MRI影像资料,并与病理学结果对比。结果 MRI诊断符合率、敏感性、特异性略高于超声造影检查,但组间比较无差异(P0.05);CT诊断准确率低于MRI、CT(P0.05)。超声造影上,良性肿瘤实性成分为主表现为从瘤体周边向内部灌注,囊性成分为主可见囊壁呈环状不均匀增厚。恶性肿瘤实性成分为主组织有不同程度的增强,多数肿瘤体内部向周边病灶强化;囊性成分为主组织囊壁及囊内分隔明显增强。CT表现上,良性肿瘤以囊性多见,增强扫描无明显强化;恶性肿瘤有"分叶征",或多房性;以实性成分为主增强扫描后呈均匀或不均匀强化,囊性成分肿块增强扫描后无明显强化。MRI表现上,良性肿瘤囊性成分为主组织信号复杂,增强扫描囊壁及间隔有轻、重度强化;实性成分组织为主可见MRI信号不规则,增强扫描后实性部分为延迟不均匀强化。恶性肿瘤以囊实性病灶或实性病灶为主,囊实性部分为T1WI低信号,T2WI高信号,囊壁多呈结节或乳头状从囊内突出囊外;实性部分T1WI等或低或混杂信号,T2WI高信号,增强扫描中重度明显强化。实性肿块信号不均匀,增强扫描后信号不均,部分见腹水、淋巴结转移或盆腔受侵。结论超声造影是鉴别诊断良恶性卵巢肿瘤的首选影像学方式之一。

Contrast-enhanced Ultrasound,CT and MRI in Ovarian Tumor Clinical Application

Objective To investigate and compare contrast-enhanced ultrasound, CT and MRI in the diagnosis of ovarian tumors.Methods Retrospective analysis 63 cases of patients with the clinical pathological diagnosis of ovarian tumors contrast-enhanced ultrasound, CT and MRI image data, and compared with pathology results.Results MRI diagnosis coincidence rate, sensitivity, specificity, slightly higher than the contrast-enhanced ultrasound examination, but is no difference between groups (P>0.05). The CT diagnostic accuracy is lower than the MRI, CT (P<0.05). Contrast-enhanced ultrasound, benign tumor or solid composition mainly show is from the surrounding the tumors had to internal perfusion, cystic components mainly visible capsule wall show cricoid uneven thickening. Malignant solid composition is mainly organization have different degrees of enhancement, most of the tumor inside the body to the peripheral lesion enhancement. Cystic components mainly organization within the capsule wall and separated. On CT manifestations, benign tumors with cystic, enhanced scan without obvious strengthening. Malignant tumors have Ye Zheng "points", or multilocular; Give priority to with solid composition is uniform or non-uniform strengthen after enhancement scanning, a cystic component mass no obvious reinforcement after enhanced scanning. MRI performance, benign cystic components is given priority to organize complex signal, cystic wall enhancement scanning interval reinforced with light and heavy. Solid component organization mainly visible MRI signal is irregular, solid part is the uneven delay after enhancement scanning reinforcement. Malignant tumor is given priority to with capsule real STD focal or real STD focal, pouch or solid tumor, solid cystic component for T1WI low signal, high T2WI signal, the capsule wall formed a nodule or papillary outside protruding out of the sac sac. Solid part of T1WI low or mixed signal, high T2WI signal, enhanced scan be excessie significantly improved. Solid tumor signal is uneven, uneven enhancement scan signal, some see ascites had invasion, lymph node metastasis or pelvic cavity.Conclusion contrast-enhanced ultrasonography is the first choice for differential diagnosis of benign and malignant ovarian tumor imaging.