CAJ | 학술논문

目的：卵巢子宫内膜样腺癌（OEC）是少见的卵巢恶性肿瘤，临床表现无特异性。本文分析OEC的MRI表现及病理基础，探讨MRI在诊断OEC中的价值。资料与方法回顾性分析经病理证实的8例OEC患者的临床资料，术前均行子宫及附件MRI平扫及增强扫描，分析其MRI及相关组织学表现。结果8例中，单侧卵巢发病6例，其中左侧3例，右侧3例；2例为双侧卵巢发病，共10个肿块。肿块最大直径为3.5~16.5 cm，平均（10.5±4.1）cm。肿瘤边界部分模糊2例，清楚6例。MRI表现：囊实性肿块8个，2个为实性肿块，信号多混杂不均，实性部分多呈稍长或短T1、稍长T2信号，囊性部分呈长T1、长T2信号；增强扫描示8个肿块表现为实性部分斑片状明显强化，仅2个肿块表现为实性部分轻、中度强化，而囊性部分均表现为囊壁强化而腔内无明显强化。2例为原发性子宫内膜癌转移至卵巢， MRI表现为子宫内膜增厚，增强扫描呈轻度不均匀强化。结论 MRI能较好地反映OEC的病理特点，清晰地显示肿瘤的形态、成分及与周围脏器的关系等，对临床诊断OEC具有重要价值。
목적：란소자궁내막양선암（OEC）시소견적란소악성종류，림상표현무특이성。본문분석OEC적MRI표현급병리기출，탐토MRI재진단OEC중적개치。자료여방법회고성분석경병리증실적8례OEC환자적림상자료，술전균행자궁급부건MRI평소급증강소묘，분석기MRI급상관조직학표현。결과8례중，단측란소발병6례，기중좌측3례，우측3례；2례위쌍측란소발병，공10개종괴。종괴최대직경위3.5~16.5 cm，평균（10.5±4.1）cm。종류변계부분모호2례，청초6례。MRI표현：낭실성종괴8개，2개위실성종괴，신호다혼잡불균，실성부분다정초장혹단T1、초장T2신호，낭성부분정장T1、장T2신호；증강소묘시8개종괴표현위실성부분반편상명현강화，부2개종괴표현위실성부분경、중도강화，이낭성부분균표현위낭벽강화이강내무명현강화。2례위원발성자궁내막암전이지란소， MRI표현위자궁내막증후，증강소묘정경도불균균강화。결론 MRI능교호지반영OEC적병리특점，청석지현시종류적형태、성분급여주위장기적관계등，대림상진단OEC구유중요개치。
PurposeTo study the MRI and pathological features of ovarian endometrioid adenocarcinoma (OEC) in order to evaluate the value of MRI in diagnosing OEC. Materials and Methods The MRI imaging features of 8 patients confirmed by surgery and pathology were analyzed retrospectively and were compared with the results of surgery and pathology. The MRI outcome and the related histological findings were further analyzed.Results Six out of the eight patients had unilateral tumor, 3 tumors in the left and the other 3 in the right; 2 patients had masses in the both ovaries. The total number of masses was ten.The diameters of the tumors ranged from 3.5 to 16.5 cm, with the average size of (10.5±4.1) cm. The border of 2 tumors was partially fuzzy and that of the other 6 was clear. The MRI scans showed that 8 tumors were cystic-solid and the other 2 were solid with heterogeneous signals. The solid components mainly presented slightly short T1 signals and long T2 signals; the cystic ones revealed long T1 and T2 signals. The enhanced scanning showed that the solid components of 8 tumors were patchy and obviously enhanced and the other 2 had mild or moderate enhancement. The cystic components were not hyper-intense. The enhanced MRI scans of two cases of primary endometrial carcinoma with metastases to the ovaries showed thickened endometrium and mild hyper-intense.Conclusion MRI can reveal the pathological features of OEC and clearly presents the forms, components and the relationship with its surroundings of tumors. Therefore, MRI is of great importance to the clinical diagnosis of OEC.