卵巢泡膜细胞瘤的MRI表现与病理对照分析

Correlation between MRI findings and pathology of ovarian thecoma

目的探讨卵泡膜细胞瘤MRI表现及其与病理的相关性,并提高其诊断水平。方法回顾性分析经手术病理证实的14例卵泡膜细胞瘤MRI表现,并与病理相对照。结果所有患者均为边界清晰的单发肿块,其中,实性肿块伴囊变9例,囊实性4例,实性1例;12例为圆形或卵圆形,2例为分叶状。肿瘤直径2.1～20 cm,平均9.8 cm;T1WI上为等或稍低信号,T2WI上主要为等信号夹杂少量高信号9例,高信号为主5例;信号不均匀13例,均匀1例;9例瘤内见斑片状坏死、囊变区,4例囊性肿块内见较多实性软组织影,1例为实性均质肿块;13例轻度强化,1例囊实病变实性部分明显强化与周围血管一致。1例伴发子宫内膜轻度增厚,1例见大量盆腔及腹腔积液。病理证实13例为良性,1例为恶性。结论 MRI可清晰显示卵泡膜细胞瘤的大小、形态及与周围组织的关系,在卵巢卵泡膜细胞瘤的诊断与鉴别诊断中具有重要价值。

Objective To study the correlation between MRI findings and pathology of ovarian thecoma,and to elevate the diagnostic level.Methods MRI findings of 14 patients with surgically and pathologically proved ovarian thecoma were retrospectively analyzed and compared with pathologic findings.Results All 14 patients presented single tumor in pelvic cavity with well-defined margin,of them,solid masses associated with cystic change were found in 9 cases,cystic-solid masses in 4 cases,and solid mass in 1 case;round or oval masses in 12 cases,lobulated masses in 2 cases.The tumoral diameters in the group patients ranged from 2.1 to 20.0 cm with mean diameter of 9.8 cm.On MR images,9 cases appeared as isointensity or slight hypointensity on T1WI and most isointensity mixed with little hyperintensity on T2WI,while other 5 cases appeared as hyperintensity on T2WI;13 cases were heterogeneous signals,1 case was homogeneous signals;9 cases had intratumoral patchy necrosis and cystic change areas,4 cases had a number of soft tissue shadows within cystic masses,and 1 case had homogeneous solid mass.After contrast-enhanced scans,13 cases appeared as slight enhancement,1 case whose cystic-solid mass appeared as obvious enhancement of solid components,which was correspondent to peripheral vessels.One case associated with slight thickening of endometrium,one case associated with a large quantity of pelvic effusion and ascites.Postoperative pathology demonstrated that there were 13 benign-and 1 malignant ovarian thcoma in the group patients.Conclusion MRI could clearly visualize the size and shape of ovarian thecomas and their relationship with peripheval tissues so that it could play the important role in the diagnosis and differential diagnosis of this disease.