【摘要】 子宫内膜异位症（endometriosis,EM）相关妇科肿瘤是一类特殊的疾病，具有独特的影像学特征和治疗方案。根据发病部位，分为子宫内膜异位相关卵巢癌（endometriosis-associated ovarian cancer,EAOC）和卵巢外EM相关恶性肿瘤。EAOC最具提示意义的磁共振成像（magnetic resonance imaging,MRI）征象为T1加权成像（T1-weighted imaging,T1WI）高信号囊液中出现强化壁结节，弥散加权成像（diffusion-weighted imaging,DWI）弥散受限，T2加权成像（T2-weighted imaging,T2WI）阴影征消失；而卵巢外EM恶变约占25%，常见位置为子宫直肠陷凹、盆底或韧带，MRI恶性征象包括T2WI中等稍高信号，增强图像病灶显著强化，DWI弥散受限，增强后显著强化。先前深部EM病灶短期增大、实性成分增多并DWI弥散受限，高度提示恶变。总之，MRI在识别卵巢和卵巢外EM的恶变中起着关键作用，了解EM恶性转化的影像学特征对早期诊断并及时给予明确治疗至关重要。随着MRI技术进步、研究深入，以及非侵入性EM检测手段认知的提升，整体诊断水平将得到显著改善，有助于减少患者面临的诊断延误问题。更多还原

【Abstract】 Endometriosis-associated gynecological tumors represent a distinct disease category with unique imaging features and management considerations. These tumors are categorized into two groups: endometriosis-associated ovarian cancer(EAOC) and extraovarian endometriosis-associated malignancies. The most sensitive magnetic resonance imaging(MRI) feature for diagnosing EAOC is the presence of an enhancing mural nodule in a cystic lesion that shows high signal intensity on T1-weighted imaging(T1WI). Additional indicators of malignancy include restricted diffusion on diffusion-weighted imaging(DWI) and loss of the shading sign on T2-weighted imaging(T2WI). Approximately 25% of endometriosis-associated malignancies are extraovarian, most commonly arising in the rectovaginal space and rectosigmoid colon. MRI characteristics suggesting malignant transformation of extraovarian endometriosis include the development of solid masses in the cul-de-sac, pelvic floor or ligaments, characterized by intermediate signal intensity on T2WI, obvious enhancement on post-contrast images, restricted diffusion on DWI, and evidence of metastatic spread. A diagnosis of endometriosis-associated malignancy should be considered when MRI reveals such lesions in women with a previous of endometriosis, or when lesions with endometriotic characteristics coexist with malignant those showing malignant features. In conclusion, MRI plays a crucial role in both the diagnosis and differential diagnosis of endometriosis-related gynecological tumors. This review provided an overview of MRI findings associated with endometriosis-related gynecological tumors at different anatomical sites. Understanding the imaging characteristics of malignant transformation is essential for early detection and timely treatment. With continued advances in MRI technology and improved knowledge of non-invasive diagnostic approaches, the overall accuracy of detecting endometriosis-associated malignancies is expected improved significantly.更多还原