卵巢卵泡膜细胞瘤的MRI和CT表现与病理分析

陈智慧; 陈任政; 姚正信; 林锦秀; 敖瑞苓

doi:10.12122/j.issn.1674-4500.2019.03.10

卵巢卵泡膜细胞瘤的MRI和CT表现与病理分析

doi: 10.12122/j.issn.1674-4500.2019.03.10

阳江市人民医院放射科，广东阳江 529500

详细信息

作者简介:
陈智慧，副主任医师，E-mail：yjchenzhihui@aliyun.com

通讯作者:
陈任政，主任医师，E-mail：13902521088@139.com

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出版历程
- 收稿日期: 2019-05-12
- 刊出日期: 2019-07-01

MRI and CT findings and pathological analysis of ovarian thecoma

Department of Radiology, Yangjiang People's Hospital, Yangjiang 529500, China

摘要

摘要: 目的分析卵巢卵泡膜细胞瘤的CT及MRI表现特征，与病理结果对照，提高其影像学的诊断水平。方法回顾分析32例经手术病理证实为卵泡膜细胞瘤患者的CT或MRI表现特征，并结合临床与病理对照。结果双侧同时发病1例，31例为单侧发病，圆形或椭圆形，大小不等，长径0.3~28.4 cm，以实性为主，CT扫描实性部分或囊壁平扫以等低混杂密度为多，MRI平扫实性部分T₁WI呈低信号，部分病灶信号欠均匀，T₂WI信号欠均匀，可呈高信号、稍低信号、高低混杂信号等，T₂WI脂肪抑制序列示11例瘤内极低信号结节；增强扫描实性部分呈渐进性轻-中度强化，9例病灶内见较多明显强化的纤细血管影；3例可见“荷包蛋”征。结论卵泡膜细胞瘤的影像学表现具有特征性，有助于术前及鉴别诊断。
- 卵巢 /
- 卵泡膜细胞瘤 /
- 影像学 /
- 纤细小血管 /
- 极低信号小结节
Abstract: ObjectiveTo analyze CT and MRI findings of ovarian thecoma and to compare with the pathological trait.MethodsCT and MRI findings of ovarian thecomas in 32 cases proved by surgery and pathology were analyzed retrospectively.ResultsOne case was bilateral,and 31 cases was singe. All nearly round or elliptic.The size of the tumors ranged from 0.3 cm to 28.4 cm, with mainly solid. The solid part or cystic wall were equivalent and low hybrid density on unenhanced CT. The rumors exhibited isointensity and hypointensity on T₁WI,heterogeneous signal on T₂WI. Eleven cases showed low signal nodules in the tumor on T₂WI-SPAIR. After contrast injection,the solid part of tumors demonstrated mild to moderate enhancement and delayed slight progressive enhancement. Nine cases showed more obvious enhancement of fine vascular shadows. Three cases showed "pocket egg" sign.ConclusionThe imaging features of thecoma are helpful in preoperative diagnosis and differential diagnosis.
- ovary /
- thecoma /
- imaging /
- fine small vessels /
- low signal nodule

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图 1 影像学表现

A: 右侧卵巢实性卵泡膜细胞瘤, 边界清, 可见外突结节, T₂WI示肿瘤信号不均匀, 部分呈地图样高信号, 部分呈低信号; B: 左侧卵巢囊实性卵泡膜细胞瘤, 实性为主, 椭圆形, 可见脐凹征, 实性部分在T₂WI上呈明显低信号, 内见多发片状、裂隙状囊变区, 呈高信号; C: 右侧卵巢实性卵泡膜细胞瘤, 中央组织较疏松, 含水成份多, 而周围纤维组织较致密, 在T₂WI像呈周围低信号, 中央高信号, 形似“荷包蛋”; 盆腔少量积液; D: 右侧卵巢实性卵泡膜细胞瘤, 边界清, T₂WI脂肪抑制像示“荷包蛋征”, 左侧见一外突结节, 呈低信号; 盆腔少量积液; E: 左侧卵巢实性卵泡膜细胞瘤, 类椭圆形, 边界清, CT增强扫描示瘤内较多纤细小血管, 但肿瘤仅呈轻中度强化; 盆腔少量积液; F: 左侧卵巢囊实性卵泡膜细胞瘤, 绝大部分呈囊性, 仅左侧见少许实性部分, 囊内可见分隔, CT增强扫描示分隔中可见纤细小血管, 实性部分呈轻度强化.

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