超声对卵巢颗粒细胞瘤的诊断特征研究  

The characteristics of ultrasound in the diagnosis of ovary granulosa cell tumor

作　　者：张一平 陈芸[1,2] ZHANG Yiping;CHEN Yun(Clinical College,Peking University Shenzhen Hospital,Anhui Medical University,Shenzhen,Guangdong 518036,China;Department of Ultrasound Imaging,Peking University Shenzhen Hospital,Shenzhen,Guangdong 518036,China)

机构地区：[1]安徽医科大学北京大学深圳医院临床学院,广东深圳518036 [2]北京大学深圳医院超声影像科,广东深圳518036

出　　处：《影像研究与医学应用》2023年第4期49-52,56,共5页Journal of Imaging Research and Medical Applications

摘　　要：目的:结合临床症状和超声表现,探讨超声在卵巢颗粒细胞瘤(granulosa cell tumor,GCT)中的诊断价值。方法:回顾性分析2015年10月—2022年5月北京大学深圳医院收治的25例经病理诊断确诊的GCT患者的超声表现和临床及病理资料。结果:卵巢颗粒细胞瘤患者临床表现为月经不规律、阴道不规则出血、绝经后出血等,均为单侧发病;超声表现可分为4种类型:①多房囊实混合肿块型9例(36%);②实性为主的囊实混合肿块10例(40%);③实性肿块型5例(20%);④单房囊肿型1例(4%);肿瘤切面最大径平均约(7.1±4.3)cm;合并子宫内膜增生7例(28%)、子宫内膜癌2例(8%)、子宫肌瘤4例(16%)。按照Adler法血流信号分级,0级1例,Ⅰ级8例,Ⅱ级12例,Ⅲ级4例,平均血流阻力指数为(0.44±0.07);卵巢-附件影像报告和数据系统(O-RADS)平均分级为(4.32±0.69);病理类型均为成人型颗粒细胞瘤(adult granulosa cell tumor,AGCT),符合超声表现。结论:卵巢颗粒细胞瘤以囊实混合性肿块的超声表现最为常见,具有一定特征性,结合异常阴道出血、经期紊乱等临床表现,对卵巢颗粒细胞瘤的诊断具有一定的提示作用;O-RADS分级可用于超声表现较难鉴别,声像图不具备一定的特征性时,指导下一步的诊疗方案。Objective Combining clinical symptoms and ultrasonographic manifestations,discussing the value of ultrasonography in the diagnosis of ovarian granulosa cell tumor(GCT).Methods The ultrasound findings,clinical and pathological data of 25 pathologically confirmed GCT patients admitted to our hospital from October 2015 to May 2022 were retrospectively analyzed.Results The clinical manifestations of ovarian granulosa cell tumor include irregular menstruation,irregular vaginal bleeding,and postmenopausal bleeding,all of which were unilateral;Ultrasound findings could be divided into 4 types:①9 cases(36%)of the multilocular cystic-solid mixed mass type;②10 cases(40%)of the predominantly solid cystic-solid mixed mass type;③5 cases(20%)of solid mass type;④1 case(4%)of unilocular cystic type;The average maximum diameter of the tumor section was about(7.1±4.3)cm;7 cases(28%)were complicated with endometrial hyperplasia,2 cases(8%)with endometrial cancer,and 4 cases(16%)with uterine fibroids.The grading of blood flow signal in the mass by Adler method,there was 1 case of grade 0,8 cases of grade I,12 cases of grade II,and 4 cases of grade III.The average blood flow resistance index was(0.44±0.07);The average grade of O-RADS was(4.32±0.69);the pathological types were all adult granulosa cell tumors(AGCT),consistent with ultrasound.Conclusion GCT are the most common ultrasound manifestations of mixed cystic and solid masses,which have certain characteristics.Combined with clinical manifestations such as abnormal vaginal bleeding and menstrual disorder,it has a certain prompting effect on the diagnosis of ovarian granulosa cell tumor;O-RADS system can be used to guide the next diagnosis and treatment plan when the ultrasound manifestations are difficult to identify and the ultrasound images do not have certain characteristics.

关 键 词：卵巢颗粒细胞瘤 超声 临床诊断 O-RADS 

分 类 号：R445.1[医药卫生—影像医学与核医学]