卵巢透明细胞癌的CT、MRI表现与病理对照分析  

CT and MRI manifestations comparison with pathological characteristics in ovarian clear cell carcinoma

作　　者：赵育英[1] 毛新峰[1] 刘东[1] 张惠美[1] 宋鹏涛[2] ZHAO Yuying;MAO Xinfeng;LIU Dong;ZHANG Huimei;SONG Pengtao(Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou 313000, P.R.China;Department of Pathology, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou 313000, P.R.China)

机构地区：[1]浙江省湖州市中心医院湖州师范学院附属湖州市中心医院放射科,浙江湖州313000 [2]浙江省湖州市中心医院湖州师范学院附属湖州市中心医院病理科,浙江湖州313000

出　　处：《医学影像学杂志》2021年第6期1042-1046,共5页Journal of Medical Imaging

摘　　要：目的探讨卵巢透明细胞癌(OCCA)的CT和MRI影像表现,以提高对该病的影像诊断水平。方法选取并分析16例经手术、病理确诊OCCA的CT、MRI表现,11例行CT平扫和增强,7例行MRI平扫和增强,3例同时行CT和MRI检查,并与病理结果相对照。结果16例均发生于单侧附件,7例来源于右侧卵巢,9例来源于左侧卵巢。11例呈圆形或椭圆形,5例呈不规则形,边缘见分叶。肿瘤主要表现为囊实性肿块,13例以囊性为主“囊中有实”,内见乳头状、结节状、团块状实性成分向囊内突起,呈岛屿状、栓子样改变,其中5例“实中有囊”,团块状实性成分中可见散在囊状影;3例以实性成分为主,病灶中央见囊性液化坏死影。CT平扫囊性成分CT值18~30 HU,实性成分35~56 HU,增强扫描囊性成分未见明显强化,实性成分呈持续明显强化;MRI表现囊性部分T1WI呈稍高/高信号影6例,T1WI呈低信号影10例,T2WI均呈高信号影,实性成分T1WI呈等低信号为主,T2WI呈高信号为主,DWI以高信号为主,增强后持续明显强化。7例病灶边缘见增粗血管影,4例肿块内见丰富血管影。结论OCCA的CT、MRI表现具有一定特异性,可以较为清晰显示肿块的囊实性改变、强化方式和供血血管,对术前诊断具有重要价值。Objective To explore CT and MRI manifestations of ovarian clear cell carcinoma,and to improve the diagnostic accuracy and understanding of the disease.Methods Imaging manifestations of 16 patients with OCCA confirmed by surgical pathology were analyzed retrospectively and compared with pathological findings.Of all the patients,11 underwent plain and enhanced CT scan,7 underwent plain and enhanced MRI scan,3 underwent both CT and MRI scan.Results Unilateral mass was revealed in all 16 cases,which localized at the right side in 7 cases,left side in 9 cases.The 11 lesions were round or oval and 5 were irregular with lobulated shape.Tumors mostly appeared cystic-solid masses.13 patients were premdominantly cystic component lump,papillary,nodule or irregular lump like solid component protruded into the capsule,exhibited insular,emboliform shape.5 cases showed cystic degeneration scattered in solid section.3 cases were solid adnexal mass with cystic or necrosis in central.On plain CT,the cystic portion of the masses was homogeneous and average attenuation was 22 HU(range 18 to 30 HU),and solid portion was 48 HU(range 33 to 56 HU).On enhanced scan,the cystic part of the tumor had no enhancement,but the solid component of the tumor showed sustained enhancement trend.The cystic part showed heterogenous signal intensity on T1WI,and high signal intensity on T2WI.There was no enhancement on postcontrast MRI.The solid component appeared iso-intensity on T1WI,high signal intensity on T2WI,and diffused restricted on diffusion-weighted images.There was obviously enhancement on post-contrast images.7 patients appeared thickening and tortuous vascular shadow at the edge of tumor,and 4 cases had it inside of the tumors.Conclusion The imaging finding of OCCA has certain characteristics.CT and MRI can accurately demonstrate cystic-solid appearance,the enhancement pattern and feeding arteries,which can provide valuable information for diagnosis.

关 键 词：卵巢 透明细胞癌 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] R814.42[医药卫生—临床医学]