MRI for differentiating ovarian endometrioid adenocarcinoma from high-grade serous adenocarcinoma.

MRI for differentiating ovarian endometrioid adenocarcinoma from high-grade serous adenocarcinoma.
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MRI 鉴别卵巢子宫内膜样腺癌和高级别浆液性腺癌

DOI:
10.1186/s13048-015-0154-2
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发表时间:
2015-04-30
影响因子:
4
通讯作者:
Fu AY
Fu AY
中科院分区:
医学3区
文献类型:
--
作者:
Li HM;Qiang JW;Xia GL;Zhao SH;Ma FH;Cai SQ;Feng F;Fu AY

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目的探讨鉴别卵巢子宫内膜样腺癌(OEC)与高级别浆液性腺癌(HGSC)的磁共振成像(MRI)特征。材料与方法对经手术和病理证实的23例25个OEC和93例139个HGSC进行常规MRI和弥散加权成像(DWI)检查。评估并比较两组肿瘤的MRI特征,包括偏侧性、大小、形状、形态、信号强度、实性成分ADC值、强化、腹水、卵巢和子宫内膜同步原发癌(SPC)以及临床分期。结果OECs以下特征明显多于HGSCs:单侧(91.3% vs 50.5%,P < 0.001)、肿块较大(80.0% vs 48.2%,P = 0.005),圆形或椭圆形(64.0% vs 17.3%,P < 0.001),以囊性为主,伴附壁结节或乳头状突起(72.0% vs 18.7%,P < 0.001),囊性成分具有同质或异质性T1WI 高信号(82.6% vs 4.3%,P < 0.001)、中度增强(52.0% vs 26.6%,P = 0.011)、无或轻度腹水(91.3% vs 57.0%,P = 0.002)和 SPC(43.5% vs 4.3%, P < 0.001)。 OEC中固体成分的ADC值(0.979 ± 0.197 × 10−3mm2/s)高于HGSC中的(0.820 ± 0.112 × 10−3mm2/s)(P = 0.002)。当主要为囊性肿块伴附壁结节或乳头状突起时,TIWI上伴有均匀等信号或高信号囊性成分中的任何一种、相对较高的ADC值和SPC时,表征OEC的敏感性、特异性、准确性以及阳性和阴性预测值分别为87.0%、93.5%、92.2%、76.9%和96.7%。 结论 常规MRI结合DWI 有助于区分 OEC 和 HGSC。
PurposeTo investigate magnetic resonance imaging (MRI) features for differentiating ovarian endometrioid adenocarcinoma (OEC) from high-grade serous adenocarcinoma (HGSC).Materials and methodsTwenty-three patients with 25 OECs and 93 patients with 139 HGSCs confirmed by surgery and pathology underwent conventional MRI and diffusion-weighted imaging (DWI). The MRI features of the tumors, including laterality, size, shape, configuration, signal intensity, ADC value of solid component, enhancement, ascites, synchronous primary cancer (SPC) of the ovary and endometrium, and clinical stage, were evaluated and compared between two groups.ResultsThe following characteristics were significantly more common for OECs than HGSCs: unilateral (91.3% vs 50.5%, P < 0.001), larger mass (80.0% vs 48.2%, P = 0.005), round or oval shape (64.0% vs 17.3%, P < 0.001), mainly cystic with mural nodules or papillary projections (72.0% vs 18.7%, P < 0.001), cystic component with homogeneous iso- or hyperintensity on T1WI (82.6% vs 4.3%, P < 0.001), moderate enhancement (52.0% vs 26.6%, P = 0.011), no or mild ascites (91.3% vs 57.0%, P = 0.002), and SPC (43.5% vs 4.3%, P < 0.001). The ADC value of the solid component was higher in OECs (0.979 ± 0.197 × 10−3mm2/s) than in HGSCs (0.820 ± 0.112 × 10−3mm2/s) (P = 0.002). When a mainly cystic mass with mural nodules or papillary projections was associated with any one of homogeneously iso- or hyperintense cystic component on TIWI, a relatively higher ADC value and SPC, the sensitivity, specificity, accuracy, and positive and negative predictive values for characterizing OEC were 87.0%, 93.5%, 92.2%, 76.9%, and 96.7%, respectively.ConclusionsConventional MRI combining DWI is helpful for differentiating OECs from HGSCs.
DOI: 10.1148/rg.313105066
发表时间: 2011-05-01
期刊: RADIOGRAPHICS
影响因子: 5.5
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