Abstract：
OBJECTIVE: We evaluated the magnetic resonance imaging (MRI) features of ovarian teratomas with somatic-type malignancy (TSMs) and benign ovarian mature cystic teratomas (MCTs) to determine the diagnostic contribution of the MRI findings for differentiating these two teratomas.
METHODS: We compared the MRI findings between ovarian TSMs (n = 10) and MCTs (n = 193), and we conducted a receiver operating characteristic (ROC) analysis to determine the MRI findings\' contribution to the differentiation of TSMs from MCTs.
RESULTS: The maximum diameters of whole lesion and the largest solid component in the TSMs were larger than those of the MCTs (p = 0.0001 and p < 0.0001, respectively). Fat tissue in solid components was seen in 73/116 (62.9%) MCTs but in none of the TSMs (p = 0.0001). Ring-like enhancement in solid components was seen in 60/116 (51.7%) MCTs and none of the TSMs (p = 0.0031). On dynamic contrast-enhanced MRI (DCE MRI), all of the solid components in the TSMs showed a high- or intermediate-risk time intensity curve (TIC), and those in 113 of the 116 (97.4%) MCTs showed a low-risk TIC (p < 0.0001). The area under the curve of the ROC analysis using the high-/intermediate-risk TIC on DCE MRI was the highest (0.99) for differentiating TSMs from MCTs: sensitivity 100%, specificity 97.4%, positive predictive value 75.0%, negative predictive value 100%, and accuracy, 97.6%.
CONCLUSIONS: Compared to ovarian MCTs, ovarian TSMs are larger and have larger solid components with high- or intermediate-risk TICs on DCE MRI. Ovarian MCTs frequently show small solid components with fat tissue, ring-like enhancement, and a low-risk TIC on DCE MRI.
METHODS: We compared the MRI findings between ovarian TSMs (n = 10) and MCTs (n = 193), and we conducted a receiver operating characteristic (ROC) analysis to determine the MRI findings\' contribution to the differentiation of TSMs from MCTs.
RESULTS: The maximum diameters of whole lesion and the largest solid component in the TSMs were larger than those of the MCTs (p = 0.0001 and p < 0.0001, respectively). Fat tissue in solid components was seen in 73/116 (62.9%) MCTs but in none of the TSMs (p = 0.0001). Ring-like enhancement in solid components was seen in 60/116 (51.7%) MCTs and none of the TSMs (p = 0.0031). On dynamic contrast-enhanced MRI (DCE MRI), all of the solid components in the TSMs showed a high- or intermediate-risk time intensity curve (TIC), and those in 113 of the 116 (97.4%) MCTs showed a low-risk TIC (p < 0.0001). The area under the curve of the ROC analysis using the high-/intermediate-risk TIC on DCE MRI was the highest (0.99) for differentiating TSMs from MCTs: sensitivity 100%, specificity 97.4%, positive predictive value 75.0%, negative predictive value 100%, and accuracy, 97.6%.
CONCLUSIONS: Compared to ovarian MCTs, ovarian TSMs are larger and have larger solid components with high- or intermediate-risk TICs on DCE MRI. Ovarian MCTs frequently show small solid components with fat tissue, ring-like enhancement, and a low-risk TIC on DCE MRI.
摘要：
目的：我们评估了卵巢畸胎瘤合并体型恶性肿瘤（TSM）和良性卵巢成熟囊性畸胎瘤（MCT）的磁共振成像（MRI）特征，以确定MRI表现对区分这两种畸胎瘤的诊断贡献。
方法：我们比较了卵巢TSM（n=10）和MCT（n=193）的MRI表现，我们进行了受试者工作特征（ROC）分析，以确定MRI发现对TSM与MCT区分的贡献。
结果：TSM中整个病变的最大直径和最大固体成分的最大直径大于MCT（分别为p=0.0001和p<0.0001）。在73/116（62.9％）MCT中可见实体成分中的脂肪组织，但在TSM中均未见（p=0.0001）。在60/116（51.7％）MCT和TSM中均未发现固体成分的环状增强（p=0.0031）。在动态对比增强MRI（DCEMRI）上，TSM中的所有固体成分均显示出高风险或中等风险的时间强度曲线（TIC），116例MCT中的113例（97.4%）显示低风险TIC（p<0.0001）。在DCEMRI上使用高/中危TIC进行ROC分析的曲线下面积最高（0.99），用于区分TSM和MCT：灵敏度100％，特异性97.4%，阳性预测值75.0%，阴性预测值100%，和准确性，97.6%。
结论：与卵巢MCT相比，在DCEMRI上，卵巢TSM较大，固体成分较大，具有高危或中危TIC。卵巢MCT经常显示有脂肪组织的小固体成分，环状增强，和DCEMRI上的低风险TIC。
方法：我们比较了卵巢TSM（n=10）和MCT（n=193）的MRI表现，我们进行了受试者工作特征（ROC）分析，以确定MRI发现对TSM与MCT区分的贡献。
结果：TSM中整个病变的最大直径和最大固体成分的最大直径大于MCT（分别为p=0.0001和p<0.0001）。在73/116（62.9％）MCT中可见实体成分中的脂肪组织，但在TSM中均未见（p=0.0001）。在60/116（51.7％）MCT和TSM中均未发现固体成分的环状增强（p=0.0031）。在动态对比增强MRI（DCEMRI）上，TSM中的所有固体成分均显示出高风险或中等风险的时间强度曲线（TIC），116例MCT中的113例（97.4%）显示低风险TIC（p<0.0001）。在DCEMRI上使用高/中危TIC进行ROC分析的曲线下面积最高（0.99），用于区分TSM和MCT：灵敏度100％，特异性97.4%，阳性预测值75.0%，阴性预测值100%，和准确性，97.6%。
结论：与卵巢MCT相比，在DCEMRI上，卵巢TSM较大，固体成分较大，具有高危或中危TIC。卵巢MCT经常显示有脂肪组织的小固体成分，环状增强，和DCEMRI上的低风险TIC。
