【摘要】 目的　探讨MR早期动态增强对良恶性卵巢肿瘤的诊断价值。方法　分析 6 8例经手术病理证实含有实质成分的卵巢肿瘤的早期动态增强表现 ,评价标准包括时间 信号曲线 (TIC)类型(共 3型 )、早期强化率、强化峰值时间和曲线斜率值。结果　良性肿瘤 19例中Ⅰ型曲线 3例 ,Ⅱ型曲线 3例 ,Ⅲ型曲线 13例 ;低度恶性肿瘤 5例中Ⅰ型曲线 4例 ,Ⅱ型曲线 1例 ,无Ⅲ型曲线 ;恶性肿瘤4 4例中Ⅰ型曲线 4 1例 ,Ⅱ型曲线 3例 ,无Ⅲ型曲线。表现为Ⅰ型和Ⅲ型曲线的良恶性卵巢肿瘤共6 1例 ,其中 16例良性肿瘤主要呈Ⅲ型曲线 (13例 ) ,4 1例恶性肿瘤全部为Ⅰ型曲线 ,无Ⅲ型曲线。良性肿瘤早期强化率低 [(6 8± 2 7) % ],强化峰值时间长 [(16 3 5 3± 5 8 5 4 )s],曲线斜率低 (3 5 6± 3 4 2 ) ;恶性肿瘤早期强化率高 [(12 8± 15 ) % ],强化峰值时间短 [(72 89± 10 84 )s],曲线斜率值高 (9 6 9±1 4 1)。良恶性肿瘤在曲线表现类型、早期强化率、强化峰值时间和曲线斜率方面差异均有显著性意义 (P <0 0 0 1)。结论　早期动态增强MR有助于良恶性卵巢肿瘤鉴别。Ⅰ型曲线提示恶性肿瘤 ,Ⅱ型曲线肿瘤性质不确定 ,Ⅲ型曲线提示良性肿瘤更多还原

【Abstract】 Objective To evaluate the value of early phase dynamic enhanced MRI in the differential diagnosis of ovarian tumors. Methods Early phase dynamic enhanced MRI findings in 68 patients with histopathologically proved ovarian tumors were analyzed. There were 19 cases of benign tumors, 5 cases of low malignant tumors, and 44 cases of malignant tumors. The signal intensity of the solid component of tumor was measured. Peak and the slope value of enhancement were determined from time-signal intensity curve (TIC). The TIC of tumors were divided into three types according to their enhancement manner. In typeⅠ, the signal intensity increased rapidly and reached a platform soon. In typeⅡ, the signal intensity increased continuously at a slope. In type Ⅲ, the signal intensity increased slowly. The TIC index of early phase, the time to peak of enhancement, and the slope value of TIC were also evaluated. Results The TIC of the 19 benign tumors included type Ⅲ in 13 cases (13/19), type Ⅱ in 3 cases (3/19), and type Ⅰ in 3 cases (3/19). There were 41 type Ⅰ TIC (41/44) and 3 type Ⅱ TIC (3/44) in the 44 case of malignant tumors. The enhancement index, the time to peak, and the slope value of the benign tumors were (68±27)%, (163.53±58.54) s, and (3.56±3.42) during the early phase respectively, while those of malignant ovarian tumors were(128±15)%, (72.89±10.84) s, and (9.69±1.41), respectively. The difference of the enhancement index, the time to peak, and the slope value between benign and malignant ovarian tumors was statistically significant (P<0.001). Conclusion The benign tumors mainly showed type Ⅲ enhancement curve, with low and delay enhancement, while the malignant ovarian tumors mostly showed type Ⅰ enhancement curve, with high and early enhancement. The early phase dynamic enhanced MR imaging was helpful in the differential diagnosis of benign and malignant ovarian tumors.更多还原