| Part ?.The differential diagnostic value of multiple-parameter 3.0T MR imaging between ovarian thecoma-fibroma tumors and broad ligament leiomyomasObjective To explore the differential diagnostic value of multiple-parameter 3.0 T magnetic resonance imaging/MRI between ovarian thecoma-fibroma tumors and broad ligament leiomyomas.Methods 15 cases of ovarian thecoma-fibroma tumors and 38 cases of broad ligament leiomyomas with pathologically proved were collected in this study.The clinical information,tumorous size,ascites,visibility of ipsilateral ovarian,endometrial thickness,MRI signal characters?appearance on T1-weighted,T2-weighted and diffusion-weighted imaging,and apparent diffusion coefficient/ADC?,enhanced degree and tumorous component were retrospectively analyzed.The contrastive analysis and multiple-factor regression analysis were used to find the important clinical or radiological factors in differential diagnosis.Results The results of contrastive analysis showed that the differences in these four factors,including visibility of ipsilateral ovarian,ADC,enhanced degree and tumorous component,reached statistically significant levels?p<0.05?.In the group of ovarian thecoma-fibroma tumors,there were 3 cases with ipsilateral ovarian visibly.The ADC was?1.22±0.14?×10-3mm2/s.Slight,moderate and obvious enhancement were observed in 12,2 and 1 case,respectively.6 cases presented pure solid lesions,2 cases were mainly solid lesions,6 cases were cystic lesions,and 1 case was mainly cystic lesions.In the group of broad ligament leiomyomas,there were 21 cases with ipsilateral ovarian visibly.The ADC was?1.37±0.23?×10-3mm2/s.Slight,moderate and obvious enhancement were observed in 10,21 and 7 cases,respectively.21 cases presented pure solid lesions,15 cases were mainly solid lesions,1 cases were cystic lesions,and 1 case was mainly cystic lesions.The differences in other clinical data?menstrual history,clinical symptoms?,tumorous size,ascites,endometrial thickness,and MRI signal characters?T1-weighted,T2-weighted and diffusion-weighted imaging?were not statistically significant between the two groups.The results of multiple-factor regression analysis showed that the ADC and enhanced degree were important predictive factors for differentiating ovarian thecoma-fibroma tumors from broad ligament leiomyomas.The area under the receiver operating characteristic curve of 53 cases was 0.908.And the sensitivity,specificity and yoden index were 93.3%,73.7%and 0.720,respectively.Conclusion There are many overlaps between ovarian thecoma-fibroma tumors and broad ligament leiomyomas on MRI plain scan,but there are different characteristics in visibility of ipsilateral ovarian,ADC value,enhanced degree and tumorous component,which are helpful for the differential diagnosis of the ovarian thecoma-fibroma tumors and broad ligament leiomyomasPart ? The differential diagnostic value of multiple-parameter3.0 T MR imaging between ovarian thecoma-fibroma tumors and adult ovarian granulosa cell tumorsObjective To evaluate the value of multiple-parameter 3.0 T magnetic resonance imaging/MRI in the differential diagnosis of ovarian thecoma-fibroma tumors and adult ovarian granulosa cell tumors.Methods 22 cases of ovarian thecoma-fibroma tumors and 12 cases of adult ovarian granulosa cell tumors confirmed by surgery and pathology were collected.The clinical information,tumor size,endometrial thickness,MRI signal?appearance on T1-weighted,T2-weighted and diffusion-weighted imaging,and apparent diffusion coefficient/ADC?,enhancement characteristics and tumor component characteristics of the two were retrospectively analyzed.Look for clinical and radiographic features that can effectively identify the two diseases.Results There were significant differences in Apparent Diffusion Coefficient?ADC?,tumor bleeding,T2 WI and DWI signal characteristics,enhancement characteristics of third-stage enhanced scanning and tumor cystic change between the two groups?p <0.05?.The specific manifestations were as follows: the average ADC value of 22 cases of thecoma-fibroma tumors was?1.20 ± 0.11?×10-3 mm2/s,4 cases of tumor bleeding,2cases of high signal,9 cases of isointensity and 11 cases of low signal on T2 WI,DWI high signal in 6 cases,isointensity in 12 cases,low signal in 4 cases,20 cases showed mild enhancement,2 cases showed moderate enhancement,the tumor had cystic changes,respectively: 11 cases without cystic change,8 cases with large cysts,1 case with small cysts and 2 cases with mixed type;The average ADC value of 12 patients with adult ovarian granulosa cell tumors was?1.00 ± 0.13?×10-3 mm2/s.There were 9cases of tumor hemorrhage,5 cases of high signal,5 cases of isointensity,2 cases of low signal on T2 WI,10 cases of high signal,1 case of isointensity signal,10 cases of high signal on DWI,1 case of isointensity,1 case of low signal,6 cases of mild enhancement and 6 cases of moderate enhancement.The cystic changes of tumor were: 3 cases without cystic change,2 cases with small cysts and 7 cases with mixed type.There was no significant difference in clinical menstruation,endometrial thickness,tumor size and cystic grade between the two groups?p > 0.05?.Conclusion Multiple-parameter 3.0 T MRI can provide more imaging information reflecting the histological characteristics of ovarian thecoma-fibroma tumors and adult ovarian granulosa cell tumors.The signal characteristics of DWI and T2 WI,ADC value,tumor enhancement degree,tumor hemorrhage and tumor cystic change form have certain significance in the preoperative diagnosis of the two diseases. |
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