| 摘要: |
| 目的:探讨原发性输卵管癌的CT及MRI影像学特征，并对误诊病例进行分析，以提高原发性输卵管癌早期诊断准确率。方法：由2名从事放射诊断工作多年的副主任医师对本组26例经手术病理证实且有完整病例资料的原发性输卵管癌的影像学资料（包括CT及MRI）进行回顾性独立分析，意见不一致时两人协商或由第三位医师决定，分析原发性输卵管癌的影像学特征及术前误诊情况。结果:26例患者共有27个病灶，其中1例为双侧发病。20例为实性，6例为囊实性，12例出现腊肠征，21例在增强后（特别是动脉期）可见边缘包膜样强化；6例囊实性病灶中均可找到不全分隔；23例合并输卵管积液或宫腔积液，17例患者伴有腹腔积液，7例发生盆腔种植性转移。术后病理证实，24例为高级别浆液性癌，1例为透明细胞癌，1例诊断为输卵管癌肉瘤，其中癌性成分为高级别浆液性癌。术前影像诊断符合4例，误诊6例，漏诊1例，术前未能明确诊断15例。2例误诊为卵巢癌，2例误诊为性索-间质类肿瘤，1例误诊为输卵管积脓，1例误诊为Castleman病。结论:典型的原发性输卵管癌有一定的影像学征象，腊肠征伴同侧输卵管继发性扩张，对于不典型的原发性输卵管癌,包膜样强化及不完全分隔是其重要的影像学特征。 |
| 关键词: 输卵管癌 计算机断层扫描 磁共振成像 误诊 影像诊断 |
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| CT and MRI Features and Analysis of Misdiagnosis in Primary Fal-lopian Tube Carcinoma |
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Dai Zhiying1, ren gang2, zhang wen qi1, li na1, li dan na1, song li zhi3
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1.Zhoushan Women and Children’s Hopital;2.Department of Radiology, Xin Hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai;3.Zhoushan Hopital
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| Abstract: |
| Objective: To investigate the CT and MRI imaging features of primary fallopian tube carcinoma (PFTC) and analyze misdiagnosed cases to improve the accuracy of early diagnosis. Methods: Imag-ing data (including CT and MRI) from 26 patients with surgically and pathologically confirmed PFTC and complete clinical records were retrospectively and independently analyzed by two associate chief physicians with extensive experience in radiological diagnosis. Discrepancies were resolved through discussion or by a third physician. The imaging characteristics of PFTC and preoperative misdiagno-ses were analyzed. Results: The 26 patients had a total of 27 lesions, including one case of bilateral involvement. Twenty lesions were solid, and six were cystic-solid. The "sausage sign" was observed in 12 cases. Capsular enhancement at the periphery, particularly prominent in the arterial phase, was seen in 21 cases. Incomplete septa were identified within all six cystic-solid lesions. Twenty-three patients had associated hydrosalpinx or intrauterine fluid collection, 17 had ascites, and 7 had pelvic implantation metastases. Postoperative pathology confirmed 24 cases as high-grade serous carcinoma, one as clear cell carcinoma, and one as fallopian tube carcinosarcoma (with the carcinomatous com-ponent being high-grade serous carcinoma). Preoperative imaging diagnosis was correct in 4 cases. There were 6 misdiagnoses, 1 missed diagnosis, and 15 cases where no definitive preoperative diag-nosis was established. Among the misdiagnoses: 2 were mistaken for ovarian cancer, 2 for sex cord-stromal tumors, 1 for pyosalpinx, and 1 for Castleman disease. Conclusion: Typical PFTC ex-hibits specific imaging signs, such as the "sausage sign" accompanied by secondary dilation of the ipsilateral fallopian tube. For atypical PFTC, capsular-like enhancement and incomplete septations are important imaging features. |
| Key words: Primary fallopian tube carcinoma Computed tomography Magnetic resonance imaging Misdiagno-sis Diagnostic accuracy |