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目的分析滑动多层磁共振成像(SMS-MRI)的技术特点,并探讨SMS-MRI在原发性卵巢癌分期中的价值。方法对15例卵巢癌患者术前行SMS-MRI扫描,扫描范围包括胸腹盆腔(从胸廓入口至盆底)。SMS-MRI扫描的主要序列有常规T_2WITSE序列、SMS-TIRM序列和SMSFLASH 2D压脂增强序列。SMS-MRI图像由两位放射科医师随机单盲阅片后进行分期诊断,并将其结果与手术病理结果对照。观察内容包括:(1)肿瘤定位(单侧或双侧);(2)局部浸润:子宫输卵管或其他盆腔组织受侵;(3)腹膜转移;(4)淋巴结转移;(5)远处转移。结果 15例均经组织病理学证实,其中浆液性囊腺癌9例,黏液性囊腺癌2例,子宫内膜样癌2例,透明细胞癌和颗粒细胞癌各1例。手术病理分期为Ⅰ期0例,Ⅱ期2例,Ⅲ期10例,Ⅳ期3例。以手术病理结果为金标准,SMS-MRI对于原发性卵巢癌总的分期准确率为100%(15/15)。SMS-MRI在卵巢癌的定位诊断、子宫输卵管局部浸润和远处转移等方面的符合率均为100%。结论结合SMS技术的MRI可在保证图像质量的情况下,在较短的时间内一次性完成体部胸腹盆腔扫描,能较准确的完成卵巢癌原发灶和转移的侦测和分期,为卵巢癌分期诊断提供了一项新的影像诊断选择。
Objective To analyze the technical characteristics of sliding multi-layer magnetic resonance imaging (SMS-MRI) and to explore the value of SMS-MRI in the staging of primary ovarian cancer. Methods Fifteen patients with ovarian cancer underwent SMS-MRI preoperatively. The scope of the scan included the chest and abdomen pelvic cavity (from the thoracic inlet to the pelvic floor). The major sequences of SMS-MRI scans are the conventional T2WITSE sequence, the SMS-TIRM sequence and the SMSFLASH 2D lipid-enhanced sequence. SMS-MRI images were staged by two radiologists at random blinded readings, and the results were compared with the surgical pathology results. Observations include: (1) tumor location (unilateral or bilateral); (2) local infiltration: invasion of the uterine tubal or other pelvic tissue; (3) peritoneal metastasis; (4) lymph node metastasis; . Results All the 15 cases were confirmed by histopathology, including 9 cases of serous cystadenocarcinoma, 2 cases of mucinous cystadenocarcinoma, 2 cases of endometrioid carcinoma, 1 case of clear cell carcinoma and granulosa cell carcinoma. There were 0 cases in stage Ⅰ, 2 cases in stage Ⅱ, 10 cases in stage Ⅲ and 3 cases in stage Ⅳ. According to the results of surgery and pathology, the total staging accuracy of SMS-MRI for primary ovarian cancer was 100% (15/15). The coincidence rates of SMS-MRI in the diagnosis of ovarian cancer, local invasion of the fallopian tube and distant metastasis were all 100%. Conclusions MRI combined with SMS can complete the chest and abdomen pelvic scan in a short time under the condition of ensuring the image quality and can accurately detect and staging the primary tumor and metastasis of ovarian cancer. Staging of ovarian cancer provides a new diagnostic imaging option.