卵巢卵泡膜细胞瘤的影像学表现及病理分析  

Imaging characteristics and pathological analysis of ovarian thecoma

作　　者：方燕燕 黄刚[2] 王莉莉[2] 王小博[2] FANG Yanyan;HUANG Gang;WANG Lili;WANG Xiaobo(Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Radiology,People's Hospital of Gansu Provine)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省人民医院放射科

出　　处：《西北国防医学杂志》2018年第12期821-825,共5页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨卵巢卵泡膜细胞瘤(ovarian thecoma,OT)的影像学表现特征,旨在提高对该病的认识及术前诊断的准确率。方法:回顾性分析31例经病理证实的OT患者的CT及MRI表现特征,并结合临床及病理资料进行对照分析。结果:MRI显示,31例OT患者中30例为单发,1例多发;15例位于卵巢左侧,16例位于卵巢右侧。肿瘤呈类圆形(22例)或分叶状(9例)的实性肿块,边界清楚。实性部分T1WI呈等低或稍低信号,T2WI呈等低信号(5例)、高低混杂信号(16例)或高信号(10例)。其中20例可见囊性改变,T2WI表现为不规则线状、点片状及云絮状高信号影,弥散加权成像(diffusion weighted imaging,DWI)呈稍高信号,增强早期病灶实性部分呈渐进性轻度强化,延迟期强化程度增加,信号强度低于子宫肌层。31例OT患者中13例行CT平扫,病灶均表现为边界清楚的低密度影,密度不均匀。其中7例同时行增强扫描,增强后4例呈轻度强化,其中2例可见血管影,3例无明显强化。31例OT患者中20例(64.5%)血清CA-125表现为不同程度升高,合并子宫肌瘤、卵巢囊肿各3例(19.4%)、子宫内膜增生2例(6.5%)、子宫内膜息肉2例(6.5%)、子宫内膜异位症1例(3.2%)、腹水和盆腔积液18例(58.1%)。结论:OT的影像学表现具有特征性,尤其T2WI独特的信号特点及渐进性增强模式可以反映其病理特征,对其诊断与鉴别诊断具有重要价值。Objective:To investigate the imaging features of ovarian thecoma(OT),and to improve the understanding of the disease and the accuracy rate of preoperative diagnosis.Methods:The CT and MRI features of thirty-one cases with OT were retrospectively analyzed,clinical and pathological data were contrasted analysis.Results:MRI showed,Thirty cases were solitary lump,one case was multiple lump.15 cases were on the left side of the ovary,and 16 cases were on the right.The tumor were solid mass with clear boundaries,22 cases were round and 9cases were lobulated.The T1 WI of the solid part showed equal or slightly lower signal,T2 WI showed slightly lower signal(5cases),high and low mixed signal(16cases)or high signal(10cases),20 cases of which showed cystic changes and T2 WI showed high-signal of patchy and cloud-like high-signal,diffusion-weighted imaging(DWI)showed a slightly higher signal,enhancing the solid part of the early lesions with asymptotically mild enhancement,increased retardation enhancement,and lower signal intensity than uterine muscle floor.Thirteen cases underwent CT plain scan,and 7of them underwent enhanced scan.The CT scan showed a low-density shadow with clear boundary and uneven density.After enhancement,4cases showed mild enhancement,2of which showed angiography,3cases was no obvious enhancement in the case.Thirty-one cases of uterine fibroids,ovarian cysts in 3cases(19.4%),endometrial hyperplasia in 2cases(6.5%),endometrial polyps in 2cases(6.5%),endometriosis in 1case(3.2%),Eighteen ascites and pelvic fluid in 18cases(58.1%),and serum CA-125 increased to varying degrees in 20cases(64.5%).Conclusion:The imaging findings of OT are characteristic,especially the unique signal characteristics and progressive enhancement mode on T2 WI can reflect its pathological features,which is of great value for the diagnosis and differential diagnosis of this tumor.

关 键 词：卵巢 卵泡膜细胞瘤 断层摄影术 磁共振成像 病理学 

分 类 号：R339.22[医药卫生—人体生理学]