MRI对卵巢颗粒细胞瘤的诊断价值

MRI diagnosis of granulose cell tumor of the ovary

目的:探讨MRI对卵巢颗粒细胞瘤(GCTO)的诊断价值。方法:回顾性分析经手术与病理证实的20例GC-TO患者的临床和MRI资料。所有病例均行MRI平扫及增强扫描。结果:20例术前MRI诊断正确16例(80%)。MRI平扫主要表现:子宫附件区边界清楚、形态较规整、包膜完整的囊性、囊实性、实性肿块。6例为囊性肿块,其中1例为单一大囊性肿块,多囊性肿块内见厚薄不一分隔,以较厚为主,囊内壁光滑,囊内容物T1WI呈等低信号,T2WI呈高信号;9例为囊实性肿块,T1WI呈等低混杂信号,T2WI呈混杂高信号,内有多发大小不等的囊性变,囊内壁光滑;5例为实性肿块,T1WI和T2WI高于同层肌肉信号。合并症:12例子宫增大,内膜增厚,3例合并子宫内膜癌(1例同时合并子宫肌瘤)、3例合并子宫肌瘤。增强扫描20例GCTO患者的肿瘤实性部分及囊壁均明显强化。结论:卵巢颗粒细胞瘤MRI表现具有一定的特征,能清晰显示其合并症,对其诊断及鉴别诊断具有重要的临床应用价值。

Objective：To investigate the value of MRI in the diagnosis of granulose cell tumor of ovary（GCTO）.Methods：The clinical and MRI findings of 20 patients with surgery and pathology confirmed GCTO were retrospectively analyzed.All patients underwent plain and enhanced MR scanning.Results：16 of the 20 patients（80%） were correctly diagnosed by MRI before surgery.The main MRI findings were adnexa mass with clear boundary,well encapsulated cystic/ cystic-solid/ solid mass.6 of the masses were cystic and single big cystic mass was assessed in one.Multi-cystic masses showed septa with various thickness but mainly with thick septa,smooth inner capsule wall and the intra-cystic contents were hypo-intense on T1WI and hyper-intense on T2WI.Cystic-solid masses were seen in 9 patients showing heterogeneous iso-/hypo intensity on T1WI and heterogeneous hyper-intensity on T2WI as well as multiple cysts with various sizes and smooth inner wall.There were 5 patients with solid mass,showing hyper-intensity compared with that of muscle on the same slice on both T1WI and T2WI.Twelve patients had enlarged uterus with endometrium thickening;3 patients associated with endometrial carcinoma（one had uterine fibroids simultaneously）,3 patients had associated uterine fibroids.The solid part and the cystic wall of the tumor showed significant enhancement after contrast administration.Conclusion：Certain characteristic MRI findings of ovarian granulosa cell tumor could be revealed,its complications could be clearly displayed,MRI showed significant clinical value in the diagnosis and differential diagnosis of this disease entity.