MRI在盆腔囊实性占位病变的诊断价值探讨(附100例)

目的探讨核磁共振成像(magnetic resonance imaging,MRI)在盆腔囊实性占位病变的诊断价值。方法纳入我院2012年10月至2015年12月所收治的100例盆腔占位病变女性患者作为研究对象,均行MRI检查方法并经手术病理证实,分析不同性质占位病变患者的MRI影像表现及良恶性病变的鉴别要点。结果100例患者中,65例为囊性占位病变,包括21例卵巢囊腺瘤、14例卵巢囊腺癌、12例卵巢子宫内膜异位囊肿、10例卵巢囊肿、8例盆腔脓肿;35例为囊实性占位病变,包括20例卵巢畸胎瘤、15例卵巢癌。盆腔良性占位病变以囊性占位居多,边界清晰,信号均匀、囊壁薄并均匀,增强一般无强化征象;恶性占位病变以囊实性混合肿块居多,形态不规则、累及范围广,囊壁厚薄不均,并可见附壁结节,T1WI、T2WI呈混杂信号,增强后囊壁及壁结节可见不同程度强化。结论 MRI具有多轴向成像、软组织分辨率高等优点,可利用其丰富成像序列、动态增强扫描对盆腔占位病变的囊实性及其来源进行判断,并进行良恶性鉴别,在诊断女性盆腔占位病变中具有较高应用价值。

A Retrospective Analysis of MRI in the Diagnosis and Differential Diagnosis of Pelvic Cystic and Solid Occupying Lesions (100 Cases Enclosed)

Objective To retrospectively analyze the value of MRI in the diagnosis of 100 cases with pelvic cystic and solid space occupying lesions.Methods One hundred cases of female patients with pelvic occupying lesions who were treated in our hospital from October 2012 to December 2015 were analyzed retrospectively. All patients underwent MRI examination. The MRI findings of patients with different kinds of occupying lesions and the key points in the differential diagnosis of benign and malignant lesions were analyzed.Results Among the 100 patients, there were 65 cases with cystic occupying lesions, including 21 cases with ovarian cystadenoma, 14 cases with ovarian cystadenocarcinoma, 12 cases with ovarian endometriosis cysts, 10 cases with ovarian cysts, 8 cases with pelvic abscess. There were 35 cases with cystic and solid occupying lesions, including 20 cases with ovarian teratoma, 15 cases with ovarian cancer. Pelvic benign placeholder lesions were mainly cystic lesions with clear boundary, uniform signal, thin and uniform cystic wall, no enhancement; Malignant lesions were mainly cystic or solid mixed mass with irregular shape, wide range of involvement, cystic wall of uneven thickness, and visible wall nodule. The lesions showed mixed signal in T1WI and T2WI. The cystic wall and wall nodule had different degrees of reinforcement after enhanced scan.Conclusion The application of MRI in pelvic cystic and solid occupying lesions has such advantage as multi-axial imaging, high resolution of soft tissues etc.. Rich imaging sequences, dynamic enhanced scanning can be applied in differential diagnosis of cystic and solid lesions, and the differential diagnosis of benign and malignant lesions. It is of great application value on female patients with pelvic occupying lesions.