浆液性卵巢肿瘤的CT诊断

CT Diagnosis of Serous Ovarian Neoplasm

目的 分析浆液性卵巢肿瘤的CT影像特征 ,探讨其良恶性表现。资料与方法 回顾分析 1996年 1月～2 0 0 1年 4月 39例 5 3个经手术病理证实为浆液性卵巢肿瘤的CT影像资料 ,对肿瘤进行定位、定性分析 ,重点观察肿瘤部位、内部密度、分隔、瘤壁、囊内外赘生物、软组织成分以及腹水、腹膜、网膜种植及淋巴结转移 ,并与手术病理所见对照 ,比较浆液性卵巢肿瘤良恶性的影像特点。结果 肿瘤位于附件区者占 6 6 % (35 / 5 3) ,最大直径 3～4 0cm。肿块影像分 3型 :Ⅰ型囊性 (n =13) ;Ⅱ型囊实性 ,包括Ⅱa型以囊性为主 (n =19) ,Ⅱb型混合性 (n =12 ) ,Ⅱc型以实性为主 (n =7) ;Ⅲ型实性 (n =2 )。结论 浆液性卵巢肿瘤最常见部位为附件区。最常见的类型为Ⅰ、Ⅱa、Ⅱb型。良性肿瘤以Ⅰ型常见 ,恶性肿瘤以Ⅱa、Ⅱb型常见。CT可很好地显示卵巢肿瘤的内部特征 ,对Ⅰ、Ⅱa。

Objective To analyze CT features of serous ovarian neoplasm and to discuss the difference in imaging signs between benign and malignant tumors. Materials and Methods CT findings in 39 patients with pathologically proved serous ovarian neoplasm, encountered during Jan. 1996～Apr. 2001, were retrospectively analyzed. The observation of the lesion was focused on the following aspects: location, internal density, septa, wall, intra and extra cystic vegetation, the composition of the soft tissue, ascites, peritonium, omental implantation and metastastic lymphadenopathy. The findings were compared with the surgical and pathological results. A comparison of imaging features between benign and malignant lesions was made. Results The tumor was located at the adnexal area in 66% of patients (35/53), with a maximum diameter varying from 3 to 40cm. The tumors were classified into three patterns. Type Ⅰ: cystic (n=19). Type Ⅱ: cyst solid, which was further subdivided into subtype Ⅱa (mainly cystic, n=19), Ⅱb (mixed, n=12) and Ⅱc (mainly solid, n=7). Type Ⅲ: solid (n=2).Conclusion Serous ovarian neoplasm mainly locates at the adnexal area. Type Ⅰ, Ⅱa and Ⅱb are most commonly seen. Type Ⅰ is commonly seen in benign tumors, while Ⅱa and Ⅱb in malignant tumors. CT scan can well reveal the inner structure of the tumor and is helpful in the differentiation of benign from malignant tumors of the type Ⅰ, Ⅱa and Ⅱb.