MRI在卵巢二元碰撞肿瘤诊断中的应用

Application of MR Imaging in Ovarian Collision Tumors

目的探讨卵巢二元碰撞肿瘤的MRI影像学特点,提高对卵巢二元碰撞肿瘤的认识。方法回顾性分析14例经手术病理证实的卵巢碰撞肿瘤。均为超声首诊,后进一步行MRI平扫及增强扫描。观察肿瘤的部位、形态、大小及MRI信号特征,并与临床及病理对照分析。结果14例肿瘤均为两种不同来源的肿瘤发生的碰撞,其中位于左侧卵巢10例、右侧卵巢4例。多房囊性10例,囊实性4例。"瘤壁瘤"12例和"瘤中瘤"2例。其中上皮-生殖来源肿瘤11例包括囊腺瘤合并畸胎瘤10例,腺纤维瘤合并畸胎瘤1例;上皮-间质来源肿瘤2例包括囊腺瘤合并卵泡膜纤维瘤1例,囊腺瘤合并卵泡膜细胞瘤1例;生殖-间质来源肿瘤1例,为畸胎瘤合并卵巢平滑肌瘤。构成二元碰撞瘤的两种肿瘤均见各自典型的MRI特点,并可明确辨别各自瘤体。结论当同卵巢出现两种(或两种以上)类型肿瘤的典型表现,及肿瘤指标多样化,而不能用一种肿瘤来解释时,应考虑碰撞肿瘤存在的可能。

Objective To explore magnetic resonance imaging findings of ovarian collision tumors.Methods A retro-spective analysis of 14 cases of ovarian collision tumors confirmed by surgery and pathology was performed.All patients were initially diagnosed by ultrasound,followed by MRI plain scan and enhanced scan.Magnetic resonance Imaging results were compared with pathologic findings.Results Ovarian collision tumors in the fourteen patients consisted of 2 types tumors,Of the 14 ovarian collision tumors,10 were located in the left ovary,and 4 in the right ovary.10 cases weremulti-locular cysticand 4 cases were solid cystic in nature.Located on the tumor wall(n=12)and inside the tumor(n=2).O-varian collision tumors consisted of surface epithelial and germ cell tumor(n=11)including cystadenoma and teratoma(n=10),adenofibroma and teratoma(n=1).Ovarian collision tumors in two cases consisted of surface epithelial tumor and sex cord-stromal tumor including cystadenoma and fibrothecoma(n=1),cystadenoma and thecoma(n=1).Ovarian colli-sion tumors in a case consisted of germ cell tumor and sex cord-stromal tumor including teratoma and leiomyoma of the ovary(n=1).Typical imaging features and signals of different tumors in ovarian collision tumors can be found on MRI.Con-clusion When the typical manifestations of two(or more than two)types of tumors in the same ovary and the diversity of tumor indicators cannot be explained by one tumor,the possibility of collision tumors should be considered.