卵巢纤维瘤和纤维卵泡膜细胞瘤的CT鉴别诊断分析

Analysis of CT differential diagnosis of ovarian fibroma and fibrous theca cell tumor

目的:分析卵巢纤维瘤和纤维卵泡膜细胞瘤的CT鉴别诊断,为CT诊断水平的提高提供临床依据。方法:选取我院2009年4月至2011年4月收治的33例经病理组织学检查确诊的卵巢纤维瘤及纤维卵泡膜细胞瘤患者,其中卵巢纤维瘤18例,纤维卵泡膜细胞瘤15例,对比两组患者临床特征及CT检查结果。结果:病理组织学检查可以发现,两种肿瘤多集中在患者左下腹部,边缘锐利,包膜清晰,卵巢纤维瘤肿瘤直径较纤维卵泡膜细胞瘤大(P<0.05),且实性较多,纤维卵泡膜细胞瘤实性、囊性各半;两组CT平扫均显示附件区边缘锐利,肿物密度与子宫肌层相似;增强扫描其强化幅度均<20 HU,与子宫肌层对比明显,但两组CT表现无明显差异;CT检查对卵巢纤维瘤、纤维卵泡膜细胞瘤诊断的一致性仅为83.3%、73.3%,误诊率达到21.2%(7/33)。结论:卵巢纤维瘤和纤维卵泡膜细胞瘤的病理组织、CT表现均无明显差异,仅免疫组化分析可进行鉴别诊断,而CT增强检查可将卵巢纤维瘤、纤维卵泡膜细胞瘤与子宫、子宫阔韧带肌瘤有效区分,是指导临床治疗方案选择的可靠方式。

Objectives：To analyze the CT differential diagnosis of ovarian fibroma and fibrous theca cell tumor to provide clinical basis for the improvement of CT diagnosis.Methods：33 cases of ovarian fibroma and fi-brous theca cell tumor patients in our hospital from April 2009 -April 2011 were selected,including 18 cases of o-varian fibroma and 15 cases of fibrous theca cell tumor.Clinical features and CT findings of the two groups were compared.Results：Through pathological examination it was found that the two kinds of tumor mainly located in left lower abdomen of patients with sharp edge and clear membrane.The diameter of ovarian fibroma was larger and soli-der than fiber theca cell tumor which is composed of half solid and half cystic （P〉0.05 ）.CT flat scan of two groups showed adnexal tumor sharp edge and the density was similar to the uterine muscle’s;the enhancement of enhanced scanning was all ＆lt;20 HU and there was no significant difference between the CT performance of two groups;in the diagnosis of ovarian fibroma and fiber theca cell tumor,the diagnosis consistency of CT was only 83. 3% and 73.3%,while the misdiagnosis rate reached 21.2% （7/33）.Conclusions：There are no significant differences in pathological tissue and CT performance between ovarian fibroma and fibrous theca cell tumor.Only immunohistochemical analysis can be used in differential diagnosis,and enhanced CT scan can distinguish ovarian fibroma,fiber theca cell tumour,uterus and broad ligament myoma of uterus,which is a reliable way to guide the selection of therapeutic schedule.