卵巢颗粒细胞瘤的MRI表现及DCE-MRI的定量分析  

MRI Manifestations of Ovarian Granulosa Cell Tumor and Quantitative Analysis by DCE-MRI

作　　者：杨慧敏 李文鑫 禹雯婧 刘新疆[1,2] YANG Huimin;LI Wenxin;YU Wenjing;LIU Xinjiang(Department of Radiology,The Affiliated Hospital of Binzhou Medical College,Binzhou 256603,China;Department of Radiology,Shanghai Pudong Hospital(Pudong Hospital of Fudan University),Shanghai 201399,China)

机构地区：[1]滨州医学院附属医院放射科,山东省滨州市256603 [2]上海市浦东医院(复旦大学附属浦东医院)放射科,上海市201399

出　　处：《中国医学计算机成像杂志》2024年第3期356-360,共5页Chinese Computed Medical Imaging

基　　金：上海市卫生健康委员会卫生行业临床研究专项立项项目(202140266);浦东新区卫生健康委卫生科技项目(PW2020A-35)。

摘　　要：目的:回顾性分析卵巢颗粒细胞瘤的MRI影像学表现,并初步探究动态对比增强MRI(DCE-MRI)定量分析在卵巢颗粒细胞瘤中的诊断价值。方法:收集本院经病理证实的10例成人型卵巢颗粒细胞瘤患者的临床信息(年龄、肿瘤指标、就诊原因)及MRI影像特征(位置、大小、信号、有无出血、盆腔积液情况),并对图像进行后处理,测量感兴趣区内的表观弥散系数(ADC)值以及DCE-MRI定量参数(Ktrans、Ve、Kep)。结果:10例患者中,70%(7/10)因月经改变、绝经后阴道流血就诊,30%(3/10)因腹痛就诊。其中9例为囊实性病变,T1WI呈等/稍高信号,T2WI呈混杂高信号,实性成分DWI呈高信号,其中6例病灶具有出血征象,7例出现盆腔积液;1例为实性病变,T1WI呈等信号,T2WI呈稍高信号,DWI呈高信号。ADC平均值:实性成分为0.895×10^(-3)mm^(2)/s;囊性成分为2.989×10^(-3)mm^(2)/s。DCE-MRI定量参数Ktrans、Kep、Ve的平均值分别为0.945 min^(-1)、1.912 min^(-1)、0.517。结论:卵巢颗粒细胞瘤好发单侧,主要以囊实性多见,具有“蜂窝状”、“海绵状”特征,病灶多伴出血,因肿瘤体积大,易出现盆腔积液;本研究囊性及实性成分ADC值较以往研究良性肿瘤ADC值低,DCE-MRI定量参数Ktrans、Ve、Kep对卵巢颗粒细胞瘤的定性诊断具有一定价值。Purpose:To analyze the MRI manifestations of ovarian granulosa cell tumors using retrospective methods,and to explore the diagnostic value of dynamic contrast-enhanced(DCE-MRI)quantitative analysis in ovarian granulosa cell tumors.Methods:Clinical information(age,tumor indicators,reason for consultation)and MRI image characteristics(location,size,signal,presence of hemorrhage,pelvic effusion status)were collected from 10 patients with pathologically confirmed adult-type ovarian granulosa cell tumors at our institution.The images were post-processed to measure apparent diffusion coeffecient(ADC)values within the perceptual region of interest as well as the DCE-MRI quantitative parameters(Ktrans,Ve,Kep).Results:Of the 10 patients,70%(7/10)presented with menstrual changes and postmenopausal vaginal bleeding,and 30%(3/10)with abdominal pain.Among them,Nine of them were cystic solid lesions with equal/slightly signals on T1WI,mixed high signals on T2WI and high signals on DWI of the solid component,and one was a solid lesion with equal signals on T1WI,slightly high signals on T2WI and high signals on DWI.Six of the lesions showed signs of haemorrhage and 7 showed pelvic effusion.The average ADC value of solid component was 0.895×10^(-3)mm^(2)/s,of the cystic component was 2.989×10^(-3)mm^(2)/s.The average values of Ktrans,Kep and Ve were 0.945 min^(-1),1.912 min^(-1) and 0.517,respectively.Conclusion:Ovarian granuloma cell tumor are prone to unilateral occurrence,mainly cystic solid,with the characteristics of"honeycomb"and"spongy".The lesions are mostly accompanied by hemorrhage.Pelvic effusion is prone to occur due to the large tumor volume.The ADC values of cystic and solid components in this study are lower than those of benign tumors in previous studies,and the quantitative parameters Ktrans,Ve,and Kep of DCE-MRI are with certain value in the qualitative diagnosis of ovarian granulosa cell tumors.

关 键 词：颗粒细胞瘤 动态对比增强磁共振成像 定量分析 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]