45例卵巢勃勒纳瘤的影像诊断及分析  

Diagnosis and analysis of 45 cases of ovarian Brenner’s tumors by imaging

作　　者：吴瑶瑶 张晓丹[2] 傅之昊 肖文波[1] WU Yaoyao;ZHANG Xiaodan;FU Zhihao;XIAO Wenbo(Department of Radiology,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Radiology,Women´s Hospital School of Medicine Zhejiang University,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属第一医院放射科,杭州310003 [2]浙江大学医学院附属妇产科医院放射科,杭州310006

出　　处：《中国研究型医院》2021年第5期57-62,共6页Chinese Research Hospitals

基　　金：浙江省自然科学基金重点项目(LZ16H180001)。

摘　　要：目的通过分析卵巢勃勒纳瘤(Brenner瘤)的影像表现,剖析误诊因素,旨在提高Brenner瘤的术前影像诊断准确率。方法搜集2013年1月至2021年4月经手术病理证实的45例卵巢Brenner瘤,回顾性分析其临床及影像资料,并鉴别其良恶性。结果 45例卵巢Brenner瘤中,1例(2.2%)为恶性病变,2例(4.4%)为交界性病变,42例(93.3%)为良性病变。良性病变中,8例合并卵巢其他病变;42例良性病变共45个病灶,其中36个呈完全实性、9个呈囊实性;良性肿瘤实质区CT平扫均呈等或稍高密度,T1WI、T2WI均呈等或低信号;在CT及MRI增强中分别有15个及26个病灶实质呈轻度强化,仅有1个病灶行CT增强后呈明显强化;12个良性Brenner瘤在CT上可见多发无定形钙化;9个囊实性的良性Brenner瘤的囊变均呈外生型。2个交界性及1个恶性Brenner瘤均呈囊实性,囊变均呈中央型,肿瘤实质增强呈中度至明显强化。45例共48个病灶,其中3个行两次影像检查,故术前共进行51次影像诊断,仅2次正确诊断为Brenner瘤,另49次影像报告为误诊或未明确诊断。结论良性Brenner瘤可呈实性、囊实性,实质部分增强扫描呈轻度强化,内部可见无定形钙化;囊实性良性Brenner瘤的囊性成分呈外生型为主。交界性及恶性Brenner瘤以囊实性为主,其实质成分增强扫描呈中度至明显强化,囊变多位于病灶中心。不同分级卵巢Brenner瘤有一定特征影像表现,有助于术前精确诊断。Objective To improve the accuracy of preoperative imaging diagnosis of Brenner’s tumor by dissecting the misdiagnosis factors and analyzing the imaging presentation of ovarian Brenner’s tumor. Methods A retrospective analysis of 45 patients’clinical and imaging data was conducted for ovarian Brenner’s tumors confirmed by surgical pathology from January 2013 to April 2021, and their benign and malignant properties were identified. Results Of the 45 ovarian Brenner’s tumors, 1(2.2%)was malignant, 2(4.4%) were borderline lesions, and 42(93.3%) were benign lesions. Among the benign lesions, 8 cases were combined with ovarian other lesions. Forty-two cases of benign Brenner tumors contain 45 lesions in total, of which 36 were completely solid, and 9 were cystic-solid. All benign tumors showed equal or slightly iso-density on CT plain scan and showed iso or low signal on T1 WI or T2 WI. Fifteen and 26 lesions showed mild parenchymal enhancement on CT and MRI enhancement, respectively. Only 1 lesion revealed obvious enhancement on the contrast-enhanced CT scan. Multiple irregular calcifications were seen on CT in 12 benign Brenner’s tumors. Nine benign Brenner tumors with cystic solidity had exophytic cystic lesions. Two borderline and 1 malignant Brenner tumors were cystic-solid, and the cystic lesions were all central, with moderate to marked enhancement of the tumor parenchyma. There were 48 lesions in 45 cases,of which 3 had 2 imaging examinations, so a total of 51 diagnostic imaging was performed before surgery.Only 2 of the 45 preoperative imaging diagnoses were correctly diagnosed as Brenner’s tumor, and the other 49 imaging reports were misdiagnosed or undiagnosed. Conclusions Benign Brenner tumor can be solid or cystic-solid. Mild enhancement on contrast-enhanced imaging scan and amorphous calcification can be found in tumor parenchyma. The cystic components of cystic-solid lesions are mainly exophytic. Contrastenhanced scans of these parenchymal components that show moderate to significant enhanc

关 键 词：勃勒纳瘤 卵巢肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R737.31[医药卫生—肿瘤]