CAJ | 학술논문

目的：探讨卵巢癌腹膜转移(PC)的 MRI 表现。方法对34例经手术、病理确诊卵巢癌 PC 患者的 MRI 资料进行回顾性分析,MRI 检查包括 T1 WI、T2 WI、MRH、DWIBS 和增强3D THRIVE 序列,分析卵巢肿瘤的类型、PC 的 MRI 表现。结果34例卵巢原发癌灶及其 PC 均呈 DWIBS 高信号,卵巢原发肿瘤均为囊实性肿块,其中Ⅱa 型12例、Ⅱb 型7例、Ⅱc 型15例。PC 表现为腹膜线状增厚2例,不规则线状增厚27例,网膜污垢状增厚19例,饼状增厚11例,肠系膜污垢样改变4例,腹腔斑块、结节、肿块34例,囊性肿块8例。PC 灶位于子宫直肠陷窝31例、膀胱旁间隙24例、网膜20例、结肠旁沟9例、右膈下/肝周11例、左膈下/脾周10例,卵巢癌及盆腔 PC 侵犯直肠26例、乙状结肠22例、子宫16例。腹水33例,腹部淋巴结肿大7例。结论结合常规 MRI与 DWIBS,能对卵巢癌 PC 做出准确的诊断。
목적：탐토란소암복막전이(PC)적 MRI 표현。방법대34례경수술、병리학진란소암 PC 환자적 MRI 자료진행회고성분석,MRI 검사포괄 T1 WI、T2 WI、MRH、DWIBS 화증강3D THRIVE 서렬,분석란소종류적류형、PC 적 MRI 표현。결과34례란소원발암조급기 PC 균정 DWIBS 고신호,란소원발종류균위낭실성종괴,기중Ⅱa 형12례、Ⅱb 형7례、Ⅱc 형15례。PC 표현위복막선상증후2례,불규칙선상증후27례,망막오구상증후19례,병상증후11례,장계막오구양개변4례,복강반괴、결절、종괴34례,낭성종괴8례。PC 조위우자궁직장함와31례、방광방간극24례、망막20례、결장방구9례、우격하/간주11례、좌격하/비주10례,란소암급분강 PC 침범직장26례、을상결장22례、자궁16례。복수33례,복부림파결종대7례。결론결합상규 MRI여 DWIBS,능대란소암 PC 주출준학적진단。
Objective To explore the MRI findings of ovarian cancer peritoneal carcinomatosis (PC).Methods MRI findings of 34 cases with advanced ovarian cancer and PC confirmed by operation and pathology were reviewed retrospectively.MRI protocols included T1 WI,T2 WI,MRH,DWIBS,and gadolinium-enhanced 3D THRIVE sequences.The type of ovarian tumor and MRI manifestations of PC were analyzed.Results All of the ovarian tumors and PC lesions were high signal intensity in DWIBS.All of the ovarian tumors were shown as mixed cystic solid masses,including type Ⅱa in 12 cases,type Ⅱb in 7 cases,and type Ⅱc in 1 5 cases.The MR manifestations of PC were described as follow:linear thickening of the peritoneum (n=2),irregular linear thickening of the peritoneum (n=27);smudged thickening of the omentum (n=1 9),cake-like thickening of the omentum (n=1 1);fouling-appearance of the mesentery (n=4);plaque,nodule and mass in the abdominal cavity (n= 34),cystic mass (n=8).PC lesions were detected in the Douglas’space in 31 cases,paravesical interspace in 24 cases,omentum in 20 cases,paracolic gutter in 9 cases, right subdiaphragmatic / parahepatic space in 1 1 cases,and left subdiaphragmatic / parasplenic space in 10 cases.The primary and PC tumors invaded the rectum in 26 cases,sigmoid in 22 cases,and uterus in 1 6 cases.Ascites and lymphadenectasis in abdomen were seen in 33 and 7 cases,respectively.Conclusion Ovarian cancer PC can be diagnosed accurately by combing DWIBS and con-ventional MRI.