目的:探讨CT和MRI对卵巢恶性间皮瘤的诊断价值。
方法:回顾性分析10例经手术病理证实的OMM患者的临床及影像学资料。
结果:(1)患者年龄27~70岁,平均年龄57.2±15.4岁。7例患者报告腹胀和疼痛,1报告下腹部不适和食欲下降,2例患者无症状。(2)报道了2例局部OMM,在局部OMM肿瘤周围观察到不完全的半环形“包膜”,而8例弥漫性OMM,其中肿瘤实质在T1WI上表现为等信号或轻度低信号。T2WI上的不均匀高信号,在DWI上显然是高强度的,增强后有明显的不均匀增强。弥漫性OMM主要不是卵巢肿块,主要表现为轻度卵巢增大,腹膜结节和不规则增厚,网膜混浊,不清楚的脂肪差距,网状或不规则增厚,它可以融合成“蛋糕形”。(3)10例患者均接受手术治疗,而9例患者在手术后接受了全身化疗或免疫治疗。所有局部OMM患者均存活。在8名弥漫型患者中,5死了,1失去了随访,2人幸存下来。
结论:OMM具有一定的临床和影像学特征。没有液化,钙化,或肿瘤中的分区。弥漫性病变中卵巢增大不明显。腹膜和网膜弥漫性增厚,上腹部早期出现壁结节和腹水,帮助诊断OMM。
To investigate the diagnostic value of computed tomography (CT) and magnetic resonance imaging (MRI) in ovarian malignant mesothelioma (OMM).
The clinical and imaging data of 10 pathologically-confirmed OMM patients were analyzed retrospectively.
(1) The patients were 27 years to 70 years old, with an average age of 57.2 ± 15.4 years. Seven patients reported abdominal distension and pain, 1 reported lower abdominal discomfort and decreased appetite, and 2 patients had no symptoms. (2) Two cases of localized OMM with incomplete semi-annular \"capsule\" observed around the localized OMM tumors were reported while 8 cases had diffuse OMM in which the tumor parenchyma showed isointense or slightly hypointense on T1WI, inhomogeneous hyperintense on T2WI, and obviously hyperintense on DWI, with obvious inhomogeneous enhancement after enhancement. Diffuse OMM was not mainly composed of ovarian masses and was mainly characterized by mild ovarian enlargement, nodular and irregular thickening of the peritoneum, cloudy omentum, unclear fat gap, and reticular or irregular thickening, which can fuse into a \"cake-shape\". (3) All 10 patients underwent surgery, while 9 patients underwent systemic chemotherapy or immunotherapy after surgery. All patients with localized OMM survived. Out of the 8 diffuse-type patients, 5 died, 1 was lost to follow-up, and 2 survived.
OMM has certain clinical and imaging characteristics. There is no liquefaction, calcification, or partition in the tumor. The ovarian enlargement in the diffuse lesion is not significant. The diffuse thickening of the peritoneum and omentum with early appearance of mural nodules and ascites in the upper abdomen, help the diagnosis of OMM.