卵巢支持-间质细胞瘤的MR表现与临床病理对照分析  

Analysis of MR imaging and clinicopathological characteristics of ovarian sertoli-leydig cell tumor

作　　者：方如旗[1] 周作福[1] 陈霞平[1] 马宏[1] 潘地铃[1] 

机构地区：[1]福建省妇幼保健院,福建福州350001

出　　处：《中国临床医学影像杂志》2017年第7期516-520,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨卵巢支持-间质细胞瘤(SLCT)的MRI表现,以提高对其诊断水平。资料和方法:回顾性分析5例经手术病理证实的SLCT MRI表现,并和临床、病理资料作对照分析。结果:本组5例,年龄26~64岁,3例有月经紊乱或闭经或不孕等去女性化表现,1例有多毛、痤疮、阴蒂肥大等男性化表现,1例表现为绝经后阴道流血症状,4例腹部可触及肿块。5例血睾酮升高。MR图像上,5例均为单侧,右侧2例,左侧3例,4例为实性,为圆形、卵圆形,T_1WI呈低信号,T_2WI呈稍高信号,DWI呈明显高信号,ADC图呈低信号,动态增强曲线呈速升-平台型,其中2例病灶内伴小囊状影,1例为多房囊实性,呈分叶状,囊性部分T_1WI呈低信号,T_2WI呈高信号,实性部分呈结节状,T_1WI呈低信号,T_2WI呈稍高信号,DWI呈高信号。病理上3例为高分化SLCT,1例为中等分化,1例为低分化,免疫组化表型,5例Inhibin-a、Vimentin均为阳性,5例EMA均为阴性。结论 :SLCT MR表现有一定特征,结合临床表现可提高术前诊断准确率,确诊依赖病理证实。Objective： To improve the diagnosis accuracy of ovarian sertoli-leydig cell tumor（SLCT）, by exploring the MRI features. Materials and Methods： The MR images and clinicopathological characteristics were analysed in five cases with SLCT verified by surgery and pathology retrospectively. Results： The ages of the five cases ranged from 26 to 64 years old, three presenting signs of defeminization such as menstrual irregularities, amenorrhea and infertility, one presenting signs of masculinization such as hirsutism, acne and clitoromegaly, one complainting postmenopausal vaginal bleeding, and four cases with abdominal mass. The secrum testosterone was increased in all 5 cases. On MR, all 5 cases were unilateral with 2 in the right and 3 in the left. Four lesions were solid of round or oval shape with tiny cysts in 2 lesions. The solid components were hypointense on T1WI and slightly hyperintense on T2WI, hyperintense on DWI and hypointense on apparent diffusion coefficient map. The time signal intensity curve（TIC） of the solid regions showed sharp peak-plat form in dynamic contrast enhanced（DCE） MR imaging. One tumor was lobulated with multilobular cyst and nodular solid portion. The cyst was hypointense on T1WI and hyperintense on T2WI, while the solid part was hypointense on T1WI, slightly hyperintense on T2WI, and hyperintense on DWI. On histopathology, three SLCT cases were well differentiated, one was moderately differentiated and one was poorly differentiated. Immunohistochemically, all 5 cases were positive with inhibin and vimentin, and negative with epithelial membrane antigen（EMA）. Conclusion： Ovarian SLCT demonstrates some characteristics on MR imaging, which will improve diagnosis accuracy combined with clinical features, and the final diagnosis usually depends on pathology.

关 键 词：卵巢肿瘤 磁共振成像 

分 类 号：R737.31[医药卫生—肿瘤]