卵巢肿瘤良恶性的HRI动态增强鉴别诊断探讨

目的探讨动态增强MRI对卵巢肿瘤良恶性的鉴别诊断价值。方法对105例卵巢肿瘤的实质成分行MRI动态增强扫描，评价标准包括强化均匀度、时间一信号强度曲线类型（共2型）、第一分钟强化率、强化峰值时间等。所有病例经手术切除后，对MRI-ROI区作病理切片，区分病变的良恶性。试用动态增强扫描特征来预测病理良恶性，进行统计学分析。结果58例良性肿瘤：45例均匀强化，13例不均匀强化。47例恶性肿瘤：8例均匀强化，39例环形或不均匀强化。Ⅰ型曲线其51例，恶性肿瘤47例，良性肿瘤6例；Ⅱ型曲线共54例，恶性肿瘤2例，良性肿瘤52例。良、恶性肿瘤第一分钟强化率分别为（74．32±28．88）％和（152．22±22．56）％，到达峰值时间分别为（172．83±70．29）s和（71．48±13．15）s。良恶性肿瘤在曲线类型、第一分钟强化率和强化峰值时间方面差异均有显著性意义（P〈0．001）。卵巢肿瘤病理微血管计数良性23例为18．6±6．78及恶性20例为23．91±9．23，良恶性差异有统计学显著性意义（P〈0．05）。结论动态增强MR有助于良恶性卵巢肿瘤鉴别。

The Evaluation of Dynamic MRI in Differentiation of Benign and Malignant Ovary Tumor

Objective To evaluate dynamic MRI in differentiation of benign and malignant ovary tumor.Methods 105 cases of ovary tumor underwent dynamic MRI.Evaluations of dynamic features included enhance homorganic,time-signal intensity,enhance rate of the first minutes and time of enhance peak.All MRI-ROI were confirmed benign or malignant in pathology.Dynamic features in ROI were compared to pathology in benign or malignant,and statistical analysis.Results 58 cases of benign tumor included 45 inhomorganic enhance and 13 homorganic enhance.47 cases of malignant tumor included 8 homorganic enhance,39 inhomorganic or circle enhance.Time-signal intensity of type Ⅰ were 50 cases which included 47 malignant and 6 benign,and type Ⅱ were 54 cases which included 2 malignant and 52 benign.Enhance rate of the first minutes were (74.32±28.88)% in benign and (152.22 ± 22.56)% in malignant.Time of enhance peak were (172.83 ± 70.29)s in benign and (71.48 ± 13.15)s in malignant.Differences of enhance homorganic,time-signal intensity,enhance rate of the first minutes and time of enhance peak between benign and malignant were significant statistically (P < 0.001).Micro vessel counted in ovary tumor of 23 benign and 20 malignant were 18.6 ± 6.78 and 23.91 ± 9.23 respectively,and were difference significant statistically (P < 0.05).Conclusions Dynamic MRI enhancement could help in differentiate ovary tumors of benign and malignant.