卵巢透明細胞癌和漿液性腺癌的磁共振特征及鑒別分析

高雅麗 彭松 田偉

[摘要] 目的 探討卵巢透明細胞癌及漿液性腺癌的MR特征及鑒別診斷。 方法 回顧性分析2019年1月至2020年10月在我院經手術病理證實的8例卵巢透明細胞癌及6例漿液性腺癌的臨床資料及腹盆腔MR平掃及增強表現特點，觀察腫塊的位置、大小、形態、信號及動態增強特征。 結果 8例卵巢透明細胞癌單側發病8例（右側5例，左側3例），最大徑為3.9～16.1 cm，邊界清晰6例，邊界欠清2例，形態規則6例，不規則2例，囊實性病變8例;6例卵巢漿液性腺癌單側5例（右側3例，左側2例），雙側1例，最大徑為3.1～9.6 cm，邊界清晰2例，邊界不清4例，形態規則1例，不規則5例，囊實性病變6例。 結論 卵巢透明細胞癌MRI表現為體積較大、邊界清晰、形態規則的囊實性腫塊，實性成分表現為邊緣光滑突向囊內的單個或多個壁結節，囊性成分所占比例較實性成分多;卵巢漿液性腺癌MRI表現為體積較小、邊界欠清、形態不規則的囊實性腫塊，實性成分表現為突向囊內及囊外生長的結節影，實性成分所占比例較囊性成分多。結合病史及不同影像表現，有利于對這兩種卵巢上皮性惡性腫瘤進行鑒別診斷，為臨床提供有價值的影像信息。

[關鍵詞] 卵巢;卵巢透明細胞癌;卵巢漿液性腺癌;磁共振

[中圖分類號] R737.3? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）24-0133-04

Magnetic resonance characteristics and differential analysis of ovarian clear cell carcinoma and serous adenocarcinoma

GAO Yali? ?PENG Song? ?TIAN Wei

Department of Radiology， Chongqing Health Center for Women and Children， Chongqing? ?400010， China

[Abstract] Objective To explore the MR characteristics and differential diagnosis of ovarian clear cell carcinoma and serous adenocarcinoma. Methods Retrospectively analyzed the clinical data and the characteristics of unenhanced and enhanced abdominal pelvic MR of 8 cases of ovarian clear cell carcinoma and 6 cases of serous adenocarcinoma who were confirmed by surgery and pathology in our hospital from January 2019 to October 2020. The location， size， shape， signal， and dynamic enhancement characteristics of the mass were observed. Results Among the 8 cases of ovarian clear cell carcinoma， there were 8 cases with unilateral disease （5 cases on the right side， 3 cases on the left side）. The largest diameter was 3.9-16.1 cm. 6 cases had clear borders. 2 cases had unclear borders， 6 cases had regular morphology. 2 cases were irregular. 8 cases had cystic and solid lesions. Among the 6 cases of serous ovarian adenocarcinoma， 5 cases were unilateral （3 cases on the right side and 2 cases on the left side）， 1 case on both sides， with a maximum diameter of 3.1-9.6 cm， 2 cases with clear borders， 4 cases with unclear borders， 1 case with regular morphology， 5 cases with an irregular shape， and 6 cases with the solid capsule. Conclusion Ovarian clear cell carcinoma MRI shows a solid cystic mass with a large volume， clear borders， and regular morphology. The solid component manifested as single or multiple wall nodules with smooth edges protruding into the capsule， and the cystic component accounts for more than the solid component. The serous ovarian adenocarcinoma MRI shows cystic and solid masses with small volume， unclear borders， and irregular shapes. The solid component appears as nodules that protrude into and out of the cyst. The solid component accounts for a larger proportion than the cystic component. Combining the medical history and different imaging manifestations is beneficial to the differential diagnosis of these two ovarian epithelial malignancies and provides valuable clinical imaging information.