卵巢硬化性间质瘤CT和MRI特征分析  

CT and MRI Features of Sclerosing Stromal Tumors of the Ovary

作　　者：段娜[1] 李莉[2] 崔建民 饶敏[4] 王洁[1] 王志飞[1] 王中秋[1] DUAN Na;LI Li;CUI Jianmin(Department of Radiology,Nanjing University of Chinese Medicine Hospital,Nanjing,Jiangsu Province 210029,P.R.China)

机构地区：[1]南京中医药大学附属医院放射科,210029 [2]南京中医药大学附属医院病理科,210029 [3]天津医科大学总医院放射科,300070 [4]上海交通大学附属瑞金医院放射科,200025

出　　处：《临床放射学杂志》2024年第11期1923-1928,共6页Journal of Clinical Radiology

基　　金：江苏省中医院科技项目(编号:Y22026)。

摘　　要：目的探讨卵巢硬化性间质瘤的CT和MRI表现。方法回顾性分析31例经手术病理证实的卵巢硬化性间质瘤患者的临床资料和14次CT及23次MRI检查数据。结果31例均为单侧单发,左侧12例(38.7%)、右侧19例(61.3%),肿瘤最大直径3.2~15.0 cm,平均(7.0±2.8)cm。肿瘤包膜光整,类圆形肿块23例(23/31,74.2%),分叶状肿块8例(8/31,25.8%)。实性肿块3例(3/31,9.7%);囊实性肿块28例(28/31,90.3%),其中囊性为主型10例占32.2%,实性为主型18例占58.1%。囊实性肿块表现为厚壁,内壁不规则呈结节、乳头状影,局部“梳齿”样改变23例(23/31,74.2%),瘤内见“湖岛征”27例(27/31,87.1%)。CT检查中2例(2/14,14.3%)瘤内见钙化。增强检查肿瘤呈明显强化22例(22/31,71.0%),肿瘤呈轻中度进行性强化9例(9/31,29.0%),典型呈血管瘤样向心性强化特征,平扫CT到动脉期净增值为(37.6±35.1)HU,平扫CT到静脉期净增值为(52.2±32.4)HU,平扫CT到延迟期净增值为(54.4±34.3)HU。MRI瘤旁见血管蒂及流空血管18例(18/23,78.3%)。病灶实性部分与臀肌的表观扩散系数(ADC)比值为1.18±0.06。结论硬化性间质瘤典型表现为类圆形囊实性肿块,内壁“梳齿”样改变,瘤内见“湖岛征”,类血管瘤样明显渐进性强化。不典型表现为实性肿块和/或轻中度进行性强化。Objective To evaluate the specific CT and MR imaging features of ovarian sclerosing stromal tumor(OSST).Methods The clinical characteristics,14 CT and 23 MR images of 31 cases of OSST confirmed by postoperative pathological examinations were analyzed retrospectively.Results All the 31 masses displayed unilateral and single,with 12 cases(38.7%)on the left side and 19 cases(61.3%)on the right side.The mean tumor diameter for all patients was 7±2.8 cm(range,3.2-15 cm).The tumors had smooth edges,of which 23 cases were rounded-like(23/31,74.2%)and 8 cases were lobulated(8/31,25.8%).There were 3 cases(3/31,9.7%)of solid mass and 28 cases(28/31,90.3%)of cystic solid mass,with the latter can be divided into cystic dominant(10/31,32.2%)and solid dominant(18/31,58.1%).The solid cystic mass showed thick wall with irregular nodules and papillar on the inner wall.The“comb-tooth”sign was seen in 23 cases(23/31,74.2%),and the“lake-island”sign was seen in 27 cases(27/31,87.1%).Two of the 14 cases(14.3%)displayed calcification on CT.There were 22 cases(22/31,71.0%)with marked enhancement,and 9 cases(29.0%)with mild to moderate successive enhancement.The typical enhancement pattern was hemangioma-like(peripheral enhancement with centripetal fill-in)at dynamic contrast-enhanced imaging.The net enhancement value of plain CT to arterial phase was 37.6±35.1 Hu,that of plain CT to venous phase was 52.2±32.4 Hu,and that of plain CT to delayed phase was 54.4±34.3 Hu.Vascular pedicles and flow voids next to tumors were seen in 18 cases(18/23,78.3%)by MRI scan.The ADC ratio of the solid component of OSST to gluteus maximus was 1.18±0.06.Conclusion Sclerosing stromal tumors typically present as a round-like,cystic solid mass with“comb-tooth”sign in the inner wall,a“lake-island”sign inner the tumor,with hemangioma-like marked successive enhancement.Atypical manifestations are solid masses and/or mild-to-moderate progressive enhancement.

关 键 词：卵巢 硬化性间质瘤 CT MRI 

分 类 号：R737.31[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44