卵巢透明细胞癌MRI影像诊断.doc

卵巢透明细胞癌MRI影像诊断 　　[摘要] 目的 探讨卵巢透明细胞癌的MRI特点。 方法 回顾分析2010年7月―2015年6月间该院8例经病理证实为卵巢透明细胞癌患者的MRI图像资料。 结果 8例病灶均为单侧发病囊实性肿块。1例形态不规则呈分叶状，7例形态规则呈圆形或类圆形。8例病灶均可见包膜。3例为单房，其余5例均为多房，囊壁尚规则。肿块囊性部分可合并出血，因出血时期不同，T1WI可呈高、中、低混杂信号，T2WI均呈高信号；实性部分表现为附壁软组织灶，T1WI呈等信号，T2W呈稍高信号，DWI呈高信号，动态增强扫描实性部分动脉期不均匀强化，延迟期逐渐强化。6例肿块可见同侧增粗卵巢静脉沿着肿瘤边缘走行。3例合并对侧附件子宫内膜样囊肿。1例合并右下肢深静脉血栓。 结论 卵巢透明细胞癌的MRI表现具有特征性，结合临床资料，可提高术前诊断的正确率 [关键词] 卵巢恶性肿瘤，透明细胞癌，磁共振成像，诊断 [中图分类号] R44 [文献标识码] A [文章编号] 1674-0742（2016）11（c）-0193-03 [Abstract] Objective To explore the MRI feature of ovarian clear cell carcinoma（OCCC）. Methods Datum of 8 OCCC patients confirmed by pathology between July 2010 and June 2015 in our hospital were retrospectively analyzed. Results Tumors were unilateral ， cystic and solid in all patients.1 case showed irregular lobulated shape， the next seven showed ovoid and round shape.8 tumors have visible capsule. 3 cases were single locular， 5 cases were muiltlocular， cystic wall were regular. cystic part of the tumor can be combined with hemorrhage， because of different bleeding times， T1WI showed hyperintense ，isointense， hypointense， T2WI all showed hyperintense. The tumors were with solid mural nodules， T1WI showed isointense， T2W and DWI showed hyperintense， and heterogeneous enhancement in arterial phase， obvious enhancement in delayed phase.6 cases showed that the ipsilateral thickening ovarian vein along the edge of the tumor. 3 cases associated with contralateral accessory endometrial cyst. 1 case associated with right lower extremity deep vein thrombosis. Conclusion MRI manifestation of OCCC have some characteristics， in combination with clinical data， can improve the preoperative diagnostic accuracy. [Key words] Malignant tumor of ovary； Clear cell carcinoma； Magnetic resonance imaging； Diagnosis 卵巢透明?胞癌（ovarian clear cell carcinoma，OCCC） 起源于苗勒氏管，是由透明细胞、鞋钉样细胞及嗜酸细胞组成的卵巢表面上皮-间质性恶性肿瘤[1]，约占上皮来源卵巢恶性肿瘤的5%～11%。其早期患者相对较多，多见于围绝经期妇女，临床症状不典型，对常规以铂类为主的化疗方案敏感性、反应率低，预后不良。目前卵巢透明细胞癌MRI表现的国内报道相对较少，术前诊断正确率低。该文回顾2010年7