被困在卵巢子宫内膜囊中的输卵管膜囊模仿恶性瘤:一个病例报告
Atsushi Yoshida1,2, Shigeshi Kohno3, Shojiro Oka4
1Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan. at4.asce@gmail.com.
Abdominal radiology (New York)
|March 17, 2025
概括
卵巢子宫内膜瘤囊可以在MRI上模仿恶性瘤. 这一案例突出了被困的卵巢膜,看起来像一个可疑的结节,强调需要仔细解释,以避免不必要的手术.
科学领域:
- 妇科瘤学 妇科瘤学
- 诊断成像 诊断成像 诊断成像
- 生殖内分泌学 生殖内分泌学
背景情况:
- 卵巢内膜质囊与卵巢癌的风险增加有关.
- 使用磁共振成像 (MRI) 将良性子宫内膜瘤与恶性卵巢瘤区分开来可能是具有挑战性的,因为具有增强对比度的结节.
- 精确的手术前分化对于选择适当的外科治疗和保持生育能力至关重要.
研究的目的:
- 报告第一个MRI发现在子宫膜被困在内宫膜囊中,模仿恶性瘤的MRI发现的案例.
- 强调在卵巢成像中识别恶性瘤的良性模仿的重要性.
主要方法:
- 一名49岁的女性出现了不典型的生殖器出血,MRI显示了右卵巢子宫内膜瘤囊与增强对比度的壁面结节.
- 结节显示T2加权的低血压和没有扩散限制,这些特征可以在恶性和良性疾病中看到.
- 进行了腹腔切除术,以确定确诊.
主要成果:
- 拉皮切除术揭示了增强结节被卵膜被困在子宫内膜囊内,没有恶性瘤的证据.
- 由于其血管性,被困的膜模仿恶性瘤,但它们缺乏扩散限制和低T2信号强度是关键的差异化因素.
结论:
- 被困的卵巢膜可以在卵巢MRI上呈现为恶性瘤的错误阳性发现.
- 放射科医生和临床医生应该考虑像输卵管膜这样的良性结构作为子宫内膜囊中恶性瘤的潜在模仿者.
- 准确解释MRI发现,包括信号特征,对于防止不必要的外科手术和保持卵巢功能至关重要.
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