卵巢恶性畸胎瘤的超声表现及误诊分析

Ovarian Malignant Teratoma: Ultrasound Findings and Misdiagnosis Analysis

目的分析卵巢恶性畸胎瘤的超声表现,探讨其超声诊断价值,分析误诊原因。资料与方法回顾性分析经手术病理证实的25例卵巢恶性畸胎瘤患者的超声资料,其中22例为未成熟畸胎瘤,3例为畸胎瘤恶变,总结其声像图特征,分析误诊病例。结果 22例未成熟畸胎瘤的超声图像可以分为以实性为主型(12例)、以囊性为主型(8例)和囊实混合型(2例),其内均可见钙化样强回声分散于低回声内,彩色多普勒血流显像表现为多血供、少血供和无血供;术前超声诊断为未成熟畸胎瘤1例(4.5%),卵巢(恶性)肿瘤8例(36.4%),其他诊断13例(59.1%)。3例畸胎瘤恶变中,2例表现为囊实混合型包块,1例超声图像仅表现为囊性成熟性畸胎瘤,恶变成分表现为典型的低回声区,术前超声均未提示畸胎瘤恶变。结论卵巢恶性畸胎瘤超声表现复杂多变,术前超声诊断率低,但其超声表现仍具有一定的特征性。

Purpose To analyze the ultrasound manifestation of ovarian malignant teratoma, and to evaluate its diagnostic value and explore reasons for its misdiagnosis. Materials and Methods A retrospective study was conducted on the ultrasound findings of 25 patients with ovarian malignmlt teratoma confirmed surgically and pathologically （22 with immature teratoma, 3 with teratoma with malignant transformation）. Their ultrasound imaging features were summarized and the reasons for misdiagnosis were further analyzed. Results The ultrasound imaging of 22 immature teratoma cases were divided into three types, namely, predominant solid components, predominant fluid components and mixed components of fluid and solid. All displayed calcification-like strong echo scattering in the low echo; color Doppler showed rich blood signal, little signal or no blood flow signal. Preoperative ultrasound presentedl case of immature teratoma （4.5%）, 8 cases of ovarian tumors （malignant） （36.4%） and 13 cases of other diagnosis （59.1%）. As to the 3 cases of teratoma with malignant transformation, the ultrasound imaging showed 2 cases were composed by fluid and solid components and that 1 case was mature cystic teratoma; typical hypoecho suggested malignant transformation. Preoperative ultrasound did not present teratoma with malignant transformation. Conclusion The ultrasound findings of ovarian malignant teratoma seem to be complicated and variable; thus the preoperative diagnosis rate is low though it still shows certain characteristics.