卵巢卵泡膜细胞瘤的CT与超声诊断

Diagnosis of ovarian theca cell tumor with CT and ultrasound

目的探讨卵巢卵泡膜细胞瘤的CT及超声特点，以提高此类肿瘤的诊断水平。方法回顾性分析经手术病理证实的18例卵泡膜细胞瘤的影像资料。18例中有8例同时行超声和CT检查，8例只行超声检查，2例只行CT检查。结果肿瘤形态呈圆形或卵圆形、部分呈分叶状，边界清晰，其中实性为主肿瘤15例，囊实性3例，肿瘤直径在2．1～15cm之间，平均为8．7cm。影像表现10例中9例CT平扫呈软组织密度，密度多均匀或稍不均匀，增强扫描肿瘤实质无明显强化或有轻度强化，1例囊实性肿瘤囊变明显，增强实质呈明显强化。16例行超声检查，由于所含细胞成分不同，声像图表现多样，但大多表现为低回声实性包块。合并盆腔少量积液4例，胸腹腔积液1例，子宫内膜增生5例，子宫内膜癌2例，子宫肌瘤3例。结论卵泡膜细胞瘤的影像表现具有一定的特征性，但确诊仍需依靠病理。

Objective To explore the features of ovarian theca cell tumor on CT and ultrasound so as to improve the di agnostic levels of such tumors. Methods The image data of 18 cases of theca cell tumor confirmed by surgical pathology were retrospectively analyzed in this work. Of these 18 cases, 8 were simultaneously subjected to ultrasonic and CT exami nation, 8 to ultrasound examination, and only 2 to CT examination. Results Mostly, the tumors were circular or ovoid shape, partly, lobulated, with clear boundaries. Of these 18 cases, 15 were, mainly solid and 3 were cystic or solid. The tumor diameters ranged from 2.1 to 15 cm, with an average of 8.7 cm. In 10 cases subjected to CT scan, the inmaging manifestations were as follows： 9 cases exhibited the soft tissue density, in which the density was uniform or less uniform, and on the enhanced scan, the solid part of the tomor presented with on obvious enhancement or mild enhancement. As for 1 case of cysticsolid tumor, the cystic alteration was obvious and the solid part was significantly enhanced. With respect to the 16 cases to routine ultrasound examination, the sonographic manifestations were diversity because the different cell components contained in the tumors, but the most exhibited the hypoechoic solid mass. In addition, there were 4 cases ac companied with small amount of pelvic effusion, 1 case of ascites and pleural fluids, 5 cases of endometrial hyperplasia, 2 cases of endometrial cancer, and 3 cases of uterine fibroids. Conclusion The imaging performance of theca cell tumor has a certain characteristic, but, the final diagnosis still needs pathological examination.