Alternative Title子宮内膜症関連卵巣癌と隆起性病変を有する良性卵巣内膜症を鑑別する因子の検討
Periodical titleMagnetic resonance in medical sciences
Note (General)type:Thesis
PURPOSE: Mural nodules and papillary projections can be seen in benign ovarian endometriosis (OE) and malignant transformation of OE (endometriosis-associated ovarian cancer [EAOC]), which can pose a challenging diagnostic dilemma to clinicians. We identify the preoperative imaging characteristics helpful to the differential diagnosis between benign OE with mural nodules and EAOC. MATERIALS AND METHODS: This was a retrospective study of 82 patients who were diagnosed pathologically to have OE with mural nodules (n = 42) and malignant transformations of these tumors (n = 40) at the Nara Medical University Hospital from January 2008 to January 2015. All patients were assessed with contrast-enhanced magnetic resonance imaging (MRI) before surgery. Patient demographics, and clinical and pathologic features were analyzed to detect the significant differences between the two groups. RESULTS: Histological examinations of resected OE tissue specimens revealed that a majority (78.6%) of the mural nodular lesions were retracted blood clots. We found that the patients with malignant mural nodules, when compared to those with benign nodules, were older, had larger cyst diameters and larger mural nodule sizes, and were more likely to exhibit a taller than wider lesion. They were also more likely to present with various signal intensities on T1-weighted images (T1WI), high-signal intensity on T2-weighted images (T2WI), a lower proportion of shading on T2WI, and were more likely to show an anterior location of the cyst. In the multivariate logistic regression analysis, "Height" (>1.5 cm) and "Height-Width ratio (HWR)" (>0.9) of mural nodules, maximum diameter of the cyst (>7.9 cm), and age at diagnosis (>43 years) were independent predictors to distinguish EAOC from OE with mural nodules. CONCLUSION: The "Height" and "HWR" of the mural nodules in the cyst may yield a novel potential diagnostic factor for differentiating EAOC from benign OE with mural nodules.
博士（医学）・乙第1415号・平成30年3月15日
©2017 Japanese Society for Magnetic Resonance in MedicineThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivativesInternational License. https://creativecommons.org/licenses/by-nc-nd/4.0/.
identifier:Magnetic resonance in medical sciences Vol.17 No.3 p.231-237 (2018)
identifier:13473182
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3431
identifier:Magnetic resonance in medical sciences, 17(3): 231-237
DOIinfo:doi/10.2463/mrms.mp.2016-0149
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2018-06-04T01:14:06+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション