卵巢卵泡膜-纤维瘤组肿瘤的超声诊断

Ultrasonic diagnosis of ovarian theca-fibroma

目的探讨卵巢卵泡膜-纤维瘤组肿瘤的超声声像图特征,以期提高诊断符合率。方法回顾性分析52例卵巢卵泡膜-纤维瘤组肿瘤(卵泡膜细胞瘤17例,卵泡膜纤维瘤29例,纤维瘤6例)的超声声像图特征,根据肿瘤后方回声变化将其分为"后方回声增强型"、"后方回声增强衰减混合型"和"后方回声衰减型"三种类型,根据病理结果进行对照分析。结果 52例卵巢卵泡膜-纤维瘤组肿瘤中,45例为实性肿瘤,7例为囊实性肿瘤,呈圆形、类圆形,边界清楚,内部呈均匀或不均匀等低回声。"后方回声增强型"18例(18/52,34.6%),病理类型为卵泡膜细胞瘤和细胞成分较多的卵泡膜纤维瘤;"后方回声增强衰减混合型"18例(18/52,34.6%),病理类型主要为卵泡膜纤维瘤和间质成分较多的卵泡膜细胞瘤;"后方回声衰减型"16例(16/52,30.8%),病理类型为纤维瘤和以纤维成分为主的卵泡膜纤维瘤。30例肿瘤行彩色多普勒血流显像探及少许血流信号。结论以肿瘤后方回声变化为诊断线索,结合其他声像图特征及相关临床表现,大多数卵泡膜-纤维瘤组肿瘤有可能获得正确的超声诊断。

Objective To investigate the ultrasonographic features of ovarian theca-fibroma in order to improve the diagnostic accuracy. Methods The ultrasonographic images in 52 theca-fibromas, including 17 thecomas, 29 fibrotheeomas and 6 fibromas, were retrospectively reviewed with the correlation to pathologic results. According to the posterior acoustic change, all tumors were classified into three types, ie ＇posterior acoustic enhancement type＇, ＇posterior acoustic enhancement attenuation mixed type＇ and ＇posterior acoustic attenuation type＇. Results 45 cases were solid tumor and 7 cases were cystic-solid tumor, these tumors were round or oval with regular contour and clear margin, homogeneously or heterogeneously iso-or hypoecho. 18 cases（18/52, 34.6%） thecama or more cell components fibrothecoma were ＇posterior acoustic enhancement type＇, 18 cases（18/52, 34.6%） fibrothecoma or more stromal elements thecama were ＇posterior acoustic enhancement attenuation mixed type＇, 16 cases（16/52, 30.8%） fibroma or more fabric composition fibrothecoma were ＇posterior acoustic attenuation type＇. Color Doppler showed hypovascularity of all tumors. Condnsion According to the diagnostic clue of the posterior acoustic changes combining with other ultrasonographic features and relevant clinical manifestations, Most of theca-fibromas possibly obtain the correct ultrasonic diagnosis.