卵巢碰撞瘤的影像表现和病理特征  

Collision tumor of ovary： imaging features and pathology

作　　者：关键[1] 王焕军[1] 陈丽丽[2] 郭燕[1] 刘明娟[1] 

机构地区：[1]中山大学附属第一医院医学影像科,广州510080 [2]中山大学附属第一医院病理科,广州510080

出　　处：《中华放射学杂志》2016年第1期22-26,共5页Chinese Journal of Radiology

摘　　要：目的探讨卵巢碰撞瘤的影像表现和病理特征。方法回顾性分析经手术病理证实且影像和临床资料完整的8例卵巢碰撞瘤患者资料。7例行盆腔CT扫描，其中5例行CT平扫及增强扫描；3例行MRI扫描，其中2例行MRI平扫和增强扫描，1例妊娠患者仅行MRI平扫；2例同时行CT、MRI平扫及增强扫描。观察不同类型肿瘤的形态、位置、大小、构成成分的密度（信号），并将肿瘤影像与病理表现进行对照。结果8例均由2种不同卵巢组织来源肿瘤构成，肿瘤的组织来源为表面上皮、生殖细胞或性索间质3种类型。病变位于左侧卵巢5例、右侧卵巢3例。6例由表面上皮来源肿瘤与生殖细胞来源肿瘤构成，包括黏液性囊腺瘤与畸胎瘤4例、浆液一黏液混合性囊腺癌与畸胎瘤1例、浆液性囊腺瘤与单胚层畸胎瘤（卵巢甲状腺肿）1例；2例由卵巢上皮来源肿瘤与性索间质来源肿瘤构成，均为黏液性囊腺瘤与卯泡膜纤维瘤。8例肿瘤均表现为较大或巨大的类圆形囊实性肿块，直径9～26cm，肿瘤内见多种密度或信号成分。碰撞瘤中生殖细胞或性索间质来源肿瘤较小，位于上皮性肿瘤囊变区内或贴附于其囊壁上，两者间有明确的分界，5例呈囊壁瘤改变，3例呈囊中瘤表现。构成碰撞瘤的卵巢上皮源性肿瘤、生殖细胞性肿瘤及性索间质来源肿瘤在CT或MRI上均可见该类肿瘤本身典型的影像征象、密度（信号）特点。结论卵巢碰撞瘤的病理和影像表现具有特征性，认识其构成和影像特征有助于实现准确、完整的术前诊断。Objective To explore imaging findings and pathological features of ovarian collision tumors. Methods A retrospective analysis of preoperative imaging findings was performed in 8 female patients with surgical-pathological proven ovarian collision tumors. CT scans were performed in 5 cases, both CT and MRI were performed in 2 cases, and non-enhanced MR scans were performed in 1 pregnancy woman. Imaging results were compared with pathologic findings. Results Ovarian collision tumors in the eight patients consisted of 2 types tumors, originated from different ovarian tissues including surface epithelial cells, germ cell, or sex cord-stromal cell. Of the 8 ovarian collision tumors, 5 were located in the left ovary, and 3 in the right ovary. Ovarian collision tumors consisted of surface epithelial tumor and germ cell tumor （n=6） including mucinous eystadenoma and teratoma （n=4）, mixed cystadenoma and teratoma （n= 1）, and serous cystadenoma and struma-ovarii （n=l）. Ovarian collision tumors in two cases consisted of surface epithelial tumor and sex cord-stromal tumor, and were mucinous cystadenoma and fibroma, respectively. Imaging findings included： all tumors in the 8 cases presented big or huge multiple complicated cystic mass with 9 to 26 cm in diameter. Germ cell tumor or sex cord-stromal tumor in collision tumor was smaller and located inside the tumor （n=3） and on the tumor wall （n=5）. The boundary between two types of tumors in ovarian collision tumor was distinct and clear. Typical imaging features and densities （signals） of different tumors in ovarian collision tumors can be found on CT or MRI. Conclusions Ovarian collision tumors has some specific imaging and pathological characteristics. Imaging examination is helpful for most accurate diagnosis of ovarian collision tumors.

关 键 词：卵巢肿瘤 磁共振成像 体层摄影术 X线计算机 病理学 

分 类 号：R737.31[医药卫生—肿瘤]