纤维卵泡膜细胞瘤的MRI表现及误诊分析

MRI features and diagnostic errors of ovarian thecoma

目的探讨纤维卵泡膜细胞瘤的磁共振成像影像学特点,提高诊断水平。方法追踪随访14例MRI诊断为纤维卵泡膜细胞瘤的病理结果,并做分析比较。结果 14例MRI拟诊为纤维卵泡膜细胞瘤患者,与病理结果比较,MRI诊断正确者10例,肿块大小为1.6cm×1.8cm×1.9cm^11.7cm×13.2cm×15.7cm,呈圆形或椭圆形4例,呈分叶状6例,10例边界均清晰。T1WI呈等信号5例,呈低信号5例;T2WI低信号2例,T2WI低信号为主伴囊变2例,T2WI等信号伴斑片状及条索状高信号4例,T2稍高信号混杂斑片状更高信号2例。增强后均呈延迟轻度强化。误诊4例,其中3例病理为平滑肌瘤,1例为硬化性间质瘤。结论仔细观察肿瘤的信号及其强化方式,有助于纤维卵泡膜细胞瘤的诊断及鉴别诊断。

Objective To analyze the MRI characteristics of ovarian thecoma,in order to improve the diagnostic accuracy.Methods The Pathology and MRI data of 14 patients with diagnosed as ovarian thecoma including followed up were analyzed retrospectively together with comparative study.Results The MRI diagnosis was correct in 10 cases with tumor size from 1.6 cm×1.8 cm×1.9 cm to 11.7 cm×13.2 cm×15.7 cm,including of 4 cases spherical in shape,6 with lobulation and 10 cases of clear border.On T1 weighted images,5 cases were in isointensity and other 5 cases in hypointensity.On T2 weighted images and other 2 cases were hypointensity,2 cases were hypointensity accompany cysts,4 cases were isointensity but mixed with patchy and moonlike hyperintensities.2 cases were confounding hyperintense.Weakly and gradual enhancement could be revealed in the parenchymal phase and delay phase.The MRI diagnosis was incorrect in 4 cases,including 3 leiomyoma,1 sclerosing stromal tumor.Conclusion Close excusing the MRI crucial various sequence signal and enhancement patterns are crucial for the diagnosis and differences of the ovarian thecoma.