Misdiagnosis and imaging features of ovarian fibrothecoma
-
摘要:
目的 探讨卵巢纤维卵泡膜细胞瘤的影像学表现，并对其误诊原因进行分析。 方法 回顾性分析我院收治并经病理证实的卵巢纤维卵泡膜细胞瘤16例女性患者的临床及影像学资料，年龄50.5±11.8岁，均行CT或MR检查。由两名放射科医生共同阅读患者CT及MR图像，描述病灶位置、大小、形态、密度、信号、强化表现，并分析该病被误诊的原因。 结果 16例卵巢纤维卵泡膜细胞瘤均为单侧发病，平均直径10.9 cm，呈不均匀信号或密度。12例病灶呈实性或以实性为主的囊实性包块，8例病灶实性部分可见T2低信号影，15例行增强扫描的病灶中，13例病灶呈轻中度不均匀强化。出现血清CA125水平增高、雌激素水平增高、盆腔积液的患者分别为9例、2例、2例。16例病灶，被误诊为上皮性肿瘤3例，子宫浆膜下或阔韧带肌瘤3例。 结论 卵巢纤维卵泡膜细胞瘤的影像学表现具有一定的特征性，但容易被误诊。 -
关键词:
- 卵巢纤维卵泡膜细胞瘤 /
- X线计算机体层摄影术 /
- 磁共振成像
Abstract: Objective To explore the imaging features and reasons of misdiagnosis in ovarian fibrothecoma. Methods The clinical and imaging data of 16 female patients with pathology confirmed ovarian fibrothecoma were analyzed by two radiologists. The patients were conducted of CT or MR imaging examinations. The location, shape, maximum diameter, signal intensity or density, and enhanced pattern of the lesions were depicted. The reasons of misdiagnosis were explored. Results The tumors involved unilateral ovaries in all 16 patients, with the average maximum diameter of 10.9 cm. All the lesions showed the inhomogeneous signal intensity or density. Twelve lesions exhibited solid or solid -predominant mixed mass, and 8 lesions were found hypointensity area of parenchymal part on T2 weighted images. With the injection of contrast to 15 cases, 13 lesions presented slightly to moderately enhancement. Increase of serum CA125, estrogen level, and pelvic effusion were found in 9, 2 and 2 patients, respectively. Of 16 cases, 3 cases were misdiagnosed for epithelial tumors, and 3 cases for subserosal fibroids of uterus or broad ligament fibroids. Conclusion The ovarian fibrothecomas exhibit certain characteristic imaging features, but they are prone to be misdiagnosed.-
Key words:
- ovarian fibrothecoma /
- X-ray tomography /
- magnetic resonance imaging
-
图 2 57岁，下腹隐痛1周，右侧卵巢纤维卵泡膜细胞瘤
附件区实性包块, 与子宫相比呈等密度改变(A), 增强扫描呈轻度强化(B, C, D), 与右前方明显强化的子宫有较大的区别(D).
-
[1] Chen VW, Ruiz B, Killeen JL, et al. Pathology and classification of ovarian tumors[J]. Cancer, 2003, 97(10 Suppl): 2631-42 [2] 侯 岩, 叶兆祥, 李绪斌, 等. 卵巢纤维瘤和纤维卵泡膜细胞瘤的CT表现[J]. 临床放射学杂志, 2013, 32(1): 84-7 [3] 何家伟, 潘爱珍, 冯燕韻, 等. 卵巢纤维卵泡膜细胞瘤的MRI表现[J]. 放射学实践, 2013, 28(8): 878-81 doi: 10.3969/j.issn.1000-0313.2013.08.018 [4] Bo MC, Park SB, Lee JB, et al. Magnetic resonance imaging features of ovarian fibroma, fibrothecoma, and thecoma[J]. Abdom Imag, 2015, 40(5): 1263-72 doi: 10.1007/s00261-014-0257-z [5] 李娴, 朱来敏, 孙新海, 等. 卵巢性索-间质肿瘤的MRI表现[J]. 第三军医大学学报, 2014, 36(16): 1738-41 [6] Wu B, Peng WJ, Gu YJ, et al. MRI diagnosis of ovarian fibrothecomas: tumour appearances and oestrogenic effect features[J]. British J Radiol, 2014, 87(1038): 20130634-9 doi: 10.1259/bjr.20130634 [7] Kleppe M, Amkreutz L, Van Gorp T, et al. Lymph-node metastasis in stage I and II sex cord stromal and malignant germ cell tumours of the ovary: A systematic review[J]. Gynecol Oncol, 2014, 133(1): 124-7 doi: 10.1016/j.ygyno.2014.01.011 [8] Jung SE, Lee JM, Rha SE, et al. CT and Mr imaging of ovarian tumors with emphasis on differential diagnosis[J]. Radiographics, 2002, 22(6): 1305-25 doi: 10.1148/rg.226025033 [9] Chen JY, Wang JH, Chen X, et al. Computed tomography and magnetic resonance imaging features of ovarian fibrothecoma[J]. Oncol Lett, 2017, 14(1, B): 1172-8 doi: 10.3892/ol.2017.6228 [10] 周 玮, 何 剑, 沈 建, 等. 卵巢纤维卵泡膜细胞瘤的影像学表现[J]. 中国医学科学院学报, 2015, 37(4): 378-83 doi: 10.3881/j.issn.1000-503X.2015.04.002 [11] 毛庆聪, 张敏鸣, 邝平定, 等. 卵泡膜瘤不同病理亚型的CT表现分析[J]. 临床放射学杂志, 2016, 35(4): 556-60 [12] 李海明, 强金伟, 赵书会, 等. 磁共振成像诊断卵巢转移瘤的价值[J]. 中国临床医学影像杂志, 2014, 25(8): 574-8 doi: 10.3969/j.issn.1008-1062.2014.08.013 [13] 方如旗, 曹代荣, 李坚, 等. 卵巢子宫内膜样癌的CT、MRI表现[J]. 中国医学影像技术, 2016, 32(9): 1409-13 [14] 卢海涛, 邢 伟, 顾正章, 等. 卵巢性索间质肿瘤的CT表现与病理对照研究[J]. 临床放射学杂志, 2016, 35(10): 1551-5 [15] 李建慧, 刘思远, 谷鹏, 等. 卵泡膜细胞瘤-纤维瘤组肿瘤的MRI影像学特点[J]. 临床放射学杂志, 2018, 37(3): 453-6 [16] Yen P, Khong K, Lamba R, et al. Ovarian fibromas and fibrothecomas: sonographic correlation with computed tomography and magnetic resonance imaging: a 5-year single-institution experience[J]. J Ultrasound Med, 2013, 32(1): 13-8 doi: 10.7863/jum.2013.32.1.13 [17] 李胜华, 孙庚喜, 马海锋, 等. 卵巢卵泡膜细胞瘤MR表现与病理对照分析[J]. 实用放射学杂志, 2016, 32(1): 156-8 doi: 10.3969/j.issn.1002-1671.2016.01.043 [18] 叶浩祥, 武庆利, 郭 健, 等. 子宫旁实性肿块的低场MR诊断价值[J]. 临床放射学杂志, 2014, 33(7): 1040-3 [19] Javadi S, Ganeshan DM, Qayyum A, et al. Ovarian Cancer, the revised FIGO staging system, and the role of imaging[J]. Am J Roentgenol, 2016, 206(6): 1351-60 doi: 10.2214/AJR.15.15199 [20] 崔延安, 李 静, 袁翠平, 等. 卵巢性索间质类肿瘤的CT、MRI特征及相关临床病理[J]. 临床放射学杂志, 2017, 36(1): 74-9 [21] Zhang H, Zhang GF, Wang TP, et al. Value of 3.0 T diffusion-weighted imaging in discriminating thecoma and fibrothecoma from other adnexal solid masses[J]. J Ovarian Res, 2013, 6(1): 58-63 doi: 10.1186/1757-2215-6-58 [22] Yin B, Li WH, Cui YF, et al. Value of diffusion-weighted imaging combined with conventional magnetic resonance imaging in the diagnosis of thecomas/fibrothecomas and their differential diagnosis with malignant pelvic solid tumors[J]. World J Surg Oncol, 2016, 14(1): 5-12 -
下载:
点击查看大图
图(2)
计量
- 文章访问数: 2827
- HTML全文浏览量: 1326
- PDF下载量: 38
- 被引次数: 0
