卵巢卵泡膜细胞瘤超声征象及漏误诊分析  

Ovarian thecoma:Ultrasonic findings and causes of missed and misdiagnosis

作　　者：郭晶晶[1] 薛恩生[1] 叶琴[1] 杨嘉嘉[1] 林学英[1] 陈志奎[1] 王艳[1] GUO Jingjing;XUE Ensheng;YE Qin;YANG Jiajia;LIN Xueying;CHEN Zhikui;WANG Yan(Department of Ultrasound,Union Hospital of Fujian Medical University,Fujian Provincial Institute of Ultrasonic Medicine,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院超声科福建省超声医学研究所,福建福州350001

出　　处：《中国医学影像技术》2020年第7期1061-1064,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察卵巢卵泡膜细胞瘤(OT)的超声征象,并分析漏误诊原因。方法回顾性分析17例经手术病理证实的OT患者,观察超声显示病灶形态、边界、内部回声、血流信号及后方回声等征象,记录诊断结果。结果17例OT共18个病灶,16例为单侧、1例为双侧病灶;2个病灶(2/18,11.11%)位于卵巢周边向外生长,16个(16/18,88.89%)位于卵巢内部。术前超声发现15个病灶,漏诊3个OT。15个超声所示OT病灶中,8个形态规则,7个呈分叶状;14个边界清楚、1个不清楚;实性12个,囊实性2个,囊性1个;11个呈内部均匀的低回声,4个为不均匀低回声;9个CDFI显示少量点状血流信号,6个无血流信号;12个无液化,3个液化,均无钙化灶;2个后方回声衰减,13个无衰减。15个病灶中,仅1个病灶术前超声正确诊断为OT;其余14个病灶中,1个超声未能定位、定性诊断,6个定位为卵巢来源肿瘤、但未明确肿瘤性质,5个误诊为卵巢恶性肿瘤或卵巢畸胎瘤,2个误诊为子宫浆膜下肌瘤或阔韧带肌瘤。结论OT超声表现缺乏特异性,易因受其他病变遮挡或与子宫浆膜下肌瘤、阔韧带肌瘤及其他卵巢肿瘤相混淆而发生漏误诊。Objective To observe the ultrasonic findings of ovarian thecoma(OT),and to analyze causes of missed and misdiagnosis.Methods Data of 17 OT patients diagnosed by pathology were retrospectively analyzed,and the shape,border,internal echo,blood signal,posterior echo and ultrasonic diagnosis of OT lesions were observed.Results There were 18 OT lesions in 17 patients,16 case with unilateral single lesion and 1 case with bilateral single lesions,2(2/18,11.11%)lesions grew outward of ovary and 16(16/18,88.89%)in the ovary.Fifteen lesions were found with preoperative ultrasound and 3 were missed.Among 15 OT lesions detected with ultrasound,the shape of 8 were regular and 7 were lobed,the border of 14 lesions were clear and of 1 obscure,12 were solid,2 were cystic and solid and 1 was cystic,11 were homogeneous hypoecho while 4 were uneven hypoecho,when CDFI found few blood signal in 9 and no blood signal in rest 6 lesions.Liquefaction was found in 3 lesions,while 12 had no liquefaction.All 15 OT lesions had no calcification,while 2 lesions had posterior echo attenuation and 13 had no attenuation.Among these 15 lesions,preoperative ultrasound only correctly diagnosed 1 lesion as OT.In the rest 14 lesions,preoperative ultrasound could not locate and quantitate 1 lesion,while located 6 lesions as ovarian source tumors,the nature of the tumor was not clear,miss diagnosed 5 as ovarian malignancy or ovarian teratoma,2 as subserous myoma of uterus/broad ligament myoma.Conclusion Ultrasonic findings of OT are lack of specificity,easy to be missed when relative small OT coexisting with other large ovarian lesions,or misdiagnosed as subserous myoma of uterus,broad ligament myoma and other ovarian tumors.

关 键 词：卵泡膜细胞瘤 超声检查 误诊 

分 类 号：R737.31[医药卫生—肿瘤] R445.1[医药卫生—临床医学]