卵巢透明细胞癌和浆液性腺癌的磁共振特征及鉴别分析

高雅丽 彭松 田伟

[摘要] 目的 探討卵巢透明细胞癌及浆液性腺癌的MR特征及鉴别诊断。 方法 回顾性分析2019年1月至2020年10月在我院经手术病理证实的8例卵巢透明细胞癌及6例浆液性腺癌的临床资料及腹盆腔MR平扫及增强表现特点，观察肿块的位置、大小、形态、信号及动态增强特征。 结果 8例卵巢透明细胞癌单侧发病8例（右侧5例，左侧3例），最大径为3.9～16.1 cm，边界清晰6例，边界欠清2例，形态规则6例，不规则2例，囊实性病变8例;6例卵巢浆液性腺癌单侧5例（右侧3例，左侧2例），双侧1例，最大径为3.1～9.6 cm，边界清晰2例，边界不清4例，形态规则1例，不规则5例，囊实性病变6例。 结论 卵巢透明细胞癌MRI表现为体积较大、边界清晰、形态规则的囊实性肿块，实性成分表现为边缘光滑突向囊内的单个或多个壁结节，囊性成分所占比例较实性成分多;卵巢浆液性腺癌MRI表现为体积较小、边界欠清、形态不规则的囊实性肿块，实性成分表现为突向囊内及囊外生长的结节影，实性成分所占比例较囊性成分多。结合病史及不同影像表现，有利于对这两种卵巢上皮性恶性肿瘤进行鉴别诊断，为临床提供有价值的影像信息。

[关键词] 卵巢;卵巢透明细胞癌;卵巢浆液性腺癌;磁共振

[中图分类号] R737.3          [文献标识码] B          [文章编号] 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.