卵巢恶性畸胎瘤的CT表现

CT manifestations of ovarian malignant teratomas

目的:分析卵巢恶性畸胎瘤的CT表现,探讨CT诊断卵巢恶性畸胎瘤的价值。方法:回顾性分析5例良性畸胎瘤恶变和19例未成熟畸胎瘤的CT资料。结果:5例良性畸胎瘤恶变均为囊性肿块,平均直径13.1cm,均有散在钙化和脂质,3例囊壁不均匀性增厚并强化,2例囊肿显示大而不规则形的头结节并有强化;19例未成熟畸胎瘤中有实性肿块17个和囊实性肿块2个,平均直径14.5cm,均有实性成分强化,18例可见散在钙化,大多有散在脂质和盘曲的带状略低密度影,7例部分肿块可见强化的血管,5例肿瘤向外突破包膜侵犯邻近脏器。全部24例中8例伴有腹水,4例有盆壁淋巴结肿大。结论:卵巢恶性畸胎瘤的CT具有一定的CT特征,了解这些特征有助于卵巢恶性畸胎瘤的诊断与鉴别。

Objective： To study the CT features of ovarian malignant teratomas. Methods： CT findings of 24 cases with pathologically proved ovarian malignant teratomas were retrospectively analyzed. The neoplasms included malignant degeneration of mature cystic teraromas （n=5） and immature teratomas （n = 19）. Results：The malignant degeneration of mature cystic teratomas presented as cystic masses of which the maximum diameter was averagely 13.1 cm. Fnci of fat and scattered calcifications were found in all 5 mature cystic terstomns with malignant transformation. Of the 5 teratomas with malignant degeneration, 3 had irregularly thick wall with enhancement and 2 had large, irregular and enhanced wall plug. On CT scan, the 19 immature teratomas presented as cystic-solid （n = 2） and inhomogeneons solid （n = 17） masses with enhanced solid component after contrast administration. The maximum diameter of immature teraromas was averagely 14.5cm. 18 immature teratomas showed scattered calcifications on CT film. Fat attenuation and curved band-like low attenuation area were found in the majority of immature teratomas. Blood vessels as well as perforation of capsule and invasion of adjacent structsure were also demonstrated. Among all the 24 cases with ovarian malignant teratomas, ascitns （ n = 8） and adencpathy （ n = 4 ） were showed. Conclusion：Ovarian malignant teratoma carries certain CT features which will benefit the diagnosis and differential diagnosis.