卵巢性索间质肿瘤的超声表现

Ultrasonic features of ovarian sex cord-stromal tumors

目的探讨卵巢性索间质肿瘤(OSCSTs)的超声表现。方法回顾性分析28例OSCSTs的临床表现、超声资料、手术及病理结果,探讨其声像图特征。结果 28例OSCSTs患者共30个肿瘤,根据超声表现分为3型:①实性型19例,分别为纤维卵泡膜瘤13例、纤维瘤4例、卵泡膜瘤2例,表现为低回声肿瘤内见条状阴影,后方回声衰减,瘤体周边可见稀疏血流信号。②规则囊实性型5例,均为纤维卵泡膜瘤囊性变,实性部分回声均匀,囊性部分囊壁光滑。③不规则囊实性型4例,为颗粒细胞瘤及纤维肉瘤各2例,呈单房或多房囊实性肿瘤,囊腔大小不等,囊壁及分隔厚薄不均,可见结节状突起,可探及丰富血流信号。结论部分OSCSTs具有较典型超声表现,结合临床及实验室检查,有助于初步诊断OSCSTs。

Objective To investigate the ultrasonic features of ovarian sex cord-stromal tumors （OSCSTs）. Methods The clinical manifestations, ultrasonic features, surgical findings and pathological results of 28 patients with OSCSTs were retrospectively analyzed. Results Totally 30 tumors in 28 patients were classified into 3 types according to the ultrasonic features. ①Solid type in 19 cases including 13 fibrotheeomas, 4 fibromas and 2 thecomas showed hypoechoic masses with stripy shadows, partially with posterior acoustic attenuation. Sparse vascular signals were detected around the tumors. ② Regular cyst-solid mixed type in 5 cases showed fihrotheeomas with cystic degeneration, which had homogeneous solid component and anechoic cystic part with smooth walls. ③Irregular cyst-solid mixed type in 4 cases, including 2 granulosa cell tumors and 2 fibrosarcomas showed unilocular or multilocular cystic-solid complex masses with single cyst or multiple varying sized cysts. The walls and septums were all irregular and thickened, occasionally with nodular protrusions. Vascularity was usually abundant inside of the masses. Conclusion Relatively typical ultrasonic features of some OSCSTs combine with clinical manifestations and laboratorial examinations are helpful to primary diagnosis of OSCSTs.