卵巢卵黄囊瘤的CT、MR表现与病理对照  

CT and MRI features of ovarian yolk sac tumor by comparing with pathology

作　　者：吴小伟[1] 聂苗苗[2] 席继辉 陈自谦[3] 

机构地区：[1]武汉大学人民医院放射科,武汉430060 [2]厦门大学附属中山医院放射科 [3]南京军区福州总医院医学影像中心

出　　处：《功能与分子医学影像学（电子版）》2015年第1期32-35,共4页Functional and Molecular Medical Imaging(Electronic Edition)

摘　　要：目的探讨卵巢卵黄囊瘤（YST）CT及MRI影像学特征,以提高对该病影像学诊断的准确率。方法回顾性分析7例经手术后病理证实的卵巢卵黄囊瘤的CT、MRI资料,其中3例术前行CT平扫及增强扫描,3例行MRI平扫与增强扫描,1例行MRI平扫。7例术前均检测血清AFP浓度。结果所有病例均为单侧发病,左侧5例,右侧2例,肿瘤最大径6.0~20.1cm,平均最大径13.5cm。CT表现：3例为巨大类圆形囊实性包块,以囊性成分居多,边界清楚,密度不均匀,实性部分均呈轻中度强化,2例见纡曲肿瘤血管影,肿瘤内部均未见明显钙化灶。MR表现：4例为类圆形巨大占位,边界清楚,3例为囊实性改变,信号混杂,其内可见囊变坏死;1例以囊性成分为主,囊壁及囊腔内有数个实性结节,3例实性部分均明显强化。病理表现：镜下观察肿瘤组织结构复杂,瘤细胞排列多样,背景基质疏松,可见特征性Schiller-Dural小体,瘤组织内可见散在分布的透明小体。7例术前血清AFP均明显升高602-48,214μg/L,平均28,823μg/L。结论卵巢卵黄囊瘤具有一定的CT、MR特征,结合临床资料及血清AFP,术前可做出正确诊断。Objective To investigate the CT and MRI features of yolk sac tumor in order to improve the diagnostic accuracy. Methods CT and MRI findings of 7 cases of pathologically confirmed yolk sac tumor were analyzed retrospectively. Plain and enhanced CT scan were performed in 3/7 cases. MRI plain and enhanced scan in 3/7 cases, and only MRI plain scan in 1/7 cases. Alpha fetal protein （AFP） concentration in serum was measured for all cases prior to the surgery. Results In all cases there were unilateral ovarian masses. 5 cases in the left side, and 2 in the right side. The maximum diameter of masses were 6.0 - 20.1 cm. The average maximum diameter was 13.5 cm. CT images showed： all the tumors were mixed solid and cystic, and predominantly cystic, with clear boundary and uneven density. The solid part of mass was moderate enhanced. 2 cases showed tortuous tumor vessels inside the tumor, there was no obvious calcification. MR images showed： the tumors in all 4 cases were huge space occupying masses with clear boundary. Among them, 3 cases Were mixed solid and cystic with heterogeneous signal, cystic necrosis area inside. The solid part of the 3 cases was obviously enhanced. The other 1 case showed cystic, with several solid nodules in the cystic wall and cavity. The average serum AFP concentration of all cases was 28, 823 μg/L with a range of 602 - 48, 214 μg/L. Conclusion Ovarian yolk sac tumors have specific CT and MRI characteristics. Correct diagnosis can be made combined with the clinical features and serum AFP concentration before the operation.

关 键 词：卵巢 卵黄囊瘤 计算机体层成像 磁共振成像 

分 类 号：R737.31[医药卫生—肿瘤] R445.2[医药卫生—临床医学]