摘要
目的 分析妊娠合并卵巢肿瘤的临床特点,探讨MRI检查在妊娠合并卵巢肿瘤患者的诊断价值。方法 回顾性分析2018年5月~2024年12月在西北妇女儿童医院就诊的67例经手术病理证实的妊娠合并卵巢肿瘤患者的MRI检查及临床资料。结果67例患者共82个肿瘤,15例双侧。肿瘤直径2.0~34.7(9.3±4.9) cm,其中成熟畸胎瘤11例,粘液性囊腺瘤11例,浆液性囊腺瘤10例,子宫内膜异位囊肿9例,黄素化囊肿7例,黄体囊肿6例,单纯性囊肿3例,交界性肿瘤4例,高级别浆液性癌3例,支持间质细胞瘤1例,无性细胞瘤1例,转移瘤1例。妊娠合并卵巢肿瘤MRI诊断准确率为91.5%,7例误诊。MRI主要表现为囊性或囊实性肿块,良性肿瘤以囊性为主,交界性或恶性肿瘤以实性为主。妊娠合并卵巢良性、交界性或恶性肿瘤患者的肿瘤大小、伴蒂扭转、肿瘤标记物升高在两组间分布比较,差异均无统计学意义(P>0.05)。7例患者因无胎心或下腹痛于孕早期终止妊娠;22例良性因腹痛或体积巨大在孕中期手术,以腹腔镜为主;30例良性及交界性通过超声随访,待足月剖宫产分娩时手术;6例恶性,1例因胎儿染色体异常终止妊娠,2例促胎肺成熟后早产并根治性手术,3例孕中期保留生育功能手术。总体妊娠结局良好。结论 妊娠合并卵巢肿瘤多为良性且无症状,MRI有助于妊娠合并卵巢肿瘤的定性诊断,为临床治疗提供依据。
Objective To analyze the clinical characteristics of ovarian tumors during pregnancy and explore the diagnostic value of MRI examination in patients with ovarian tumors during pregnancy.Methods This retrospective study analyzed MRI findings and clinical data from 67 pregnant patients diagnosed with ovarian tumors during pregnancy confirmed by postoperative histopathology.Results A total of 82 ovarian tumors were identified in 67 patients,with 15 cases exhibiting bilateral involvement.Tumor diameters ranged from 2.0-34.7(9.3±4.9)cm.Histopathological subtypes included:11 mature cystic teratomas,11 mucinous cystadenomas,10 serous cystadenomas,9 endometriotic cysts,7 luteinized cysts,6 corpus luteum cysts,3 simple cysts,4 borderline tumors,3 high-grade serous carcinomas,1 sex cord-stromal tumor,1 dysgerminoma,and 1 metastatic tumor.MRI demonstrated a diagnostic accuracy of 91.5%,with 7 cases misdiagnosed.Most ovarian tumors appeared as cystic or cystic-solid masses.Benign tumors predominantly presented as cystic lesions,whereas borderline and malignant tumors tended to show solid components.No statistically significant differences were observed between benign,borderline,and malignant tumor groups regarding tumor size,presence of pedicle torsion,or elevation of tumor markers(P>0.05).In terms of clinical management and outcomes:7 patients underwent pregnancy termination during the first trimester due to absence of fetal heart tones or lower abdominal pain;22 patients with benign tumors underwent surgery during the second trimester,primarily via laparoscopy,due to abdominal pain or large tumor size;30 patients with benign or borderline tumors were monitored via ultrasound and underwent tumor resection during term cesarean section.Among 6 patients with malignant tumors,1 terminated the pregnancy due to fetal chromosomal abnormalities,2 experienced preterm delivery following fetal lung maturation and subsequently underwent radical surgery,and 3 underwent fertility-sparing surgery during the second trimester.Overall,maternal and fetal outcomes were favorable.Conclusion Ovarian tumors during pregnancy are predominantly benign and asymptomatic.MRI is a valuable tool for the qualitative assessment of these tumors,supporting accurate diagnosis and informed clinical decision-making.
作者
宁艳云
闫锐
NING Yanyun;YAN Rui(Medical Imaging Center,Northwest Women's and Children's Hospital,Xi'an 710061,China)
出处
《分子影像学杂志》
2025年第9期1130-1136,共7页
Journal of Molecular Imaging
基金
陕西省科技厅重点研发计划(2024SF-YBXM-239)。
关键词
卵巢肿瘤
妊娠
磁共振成像
临床
妊娠结局
ovarian tumor
pregnancy
magnetic resonance imaging
clinical
pregnancy outcome
