卵巢Brenner瘤的影像特征及鉴别诊断  

Radiological features and differential diagnosis of ovarian Brenner tumors

作　　者：许海珍[1] 赵俊功 XU Haizhen;ZHAO Jungong(Department of Radiology,the Eighth People’s Hospital of Shanghai,Shanghai 200232,China;Department of Radiology,the Sixth People's Hospital of Shanghai,Shanghai 200235,China)

机构地区：[1]上海市第八人民医院放射科,上海200232 [2]上海市第六人民医院放射科,上海200235

出　　处：《实用放射学杂志》2021年第8期1317-1321,共5页Journal of Practical Radiology

摘　　要：目的评价卵巢Brenner瘤在CT、MRI上的特征,提高卵巢Brenner瘤的术前诊断水平。方法回顾性分析经手术病理证实的20例Brenner瘤和31例附件区其他实性肿瘤患者的临床影像学资料,对肿瘤大小、部位、密度及信号特征以及强化程度等进行统计学分析。结果卵巢Birenner瘤多发生在绝经期妇女,常合并有黏液性囊腺瘤。CT表现囊实性或实性肿块,肿块内伴有钙化,强化略高于同层子宫肌层,差异无显著性(P>0.05);MRI显示肿瘤实性部分T_(2)WI信号低于同层面骨骼肌信号,肿瘤实性部分强化低于同层面子宫肌层信号并且高于同层面骨骼肌信号,不伴腹盆腔积液。而卵泡膜纤维瘤虽也表现为T_(2)WI低信号,但强化多低于卵巢Brenner瘤,常伴有腹盆腔积液;阔韧带肌瘤表现为实性肿块,强化程度高于Brenner瘤。Brenner瘤这些特点与附件区易混淆的肿瘤存在显著差异(P<0.05)。结论卵巢Brenner瘤CT表现实性或囊实性病灶,瘤体内常伴有钙化;肿瘤实性部分MRI则表现为T_(2)WI低信号,强化程度低于同层面子宫肌层信号并且高于同层面骨骼肌信号,这些半定量特点有助于与易混淆的附件区其他实性肿瘤相鉴别。Objective To evaluate the CT and MRI features of ovarian Brenner tumors and to improve the preoperative diagnosis level of ovarian Brenner tumors.Methods The clinical and radiological findings of 20 patients with Brenner tumors and 31 patients with other adnexal solid tumors pathologically confirmed were analyzed retrospectively.The tumors size,location,density and signal intensity as well as tumor enhancement degree were studied.Each parameter was statistically analyzed.Results Ovarian Brenner tumor showed a higher incidence in postmenopausal women and were often accompanied with mucinous cystadenoma.The Brenner tumor was featured with solid cystic or solid mass with calcification on CT examination,which was slightly higher enhanced than that in the same layer of myometrium.There was no significant difference statistically(P>0.05).The signal intensity of solid part of the mass on T_(2)WI was lower than that of the skeletal muscle at the same layer.On enhancement,the signal intensity of ovarian Brenner tumors was lower than that of the myometrium,but higher than that of skeletal muscle.Furthermore,abdominal and pelvic effusion was seldom found in Brenner tumors.Although thecofibroma also presented relatively low signal intensity on T_(2) Wl,it was often accompanied with peritoneal effusion,and the degree of enhancement was lower than that of the Brenner tumor.Broad ligament leiomyomas,as a typical solid mass,featured with higher degree of enhancement than Brenner tumors.All these characteristics of Brenner tumor were significantly different from other adnexal masses(P<0.05).Conclusion CT scan revealed that most Brenner tumor presented as solid or solid cystic mass with calcification.The solid part of Brenner tumor showed hypointensity on T_(2)WI,with lower degree of enhancement than that of myometrium uterus,and higher than that of skeletal muscle.These semi-quantitative imaging features of Brenner tumor might help to differentiate it from other adnexal solid tumors.

关 键 词：卵巢BRENNER瘤 磁共振成像 计算机体层成像 

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