卵巢颗粒瘤影像诊断与临床治疗

Imaging Diagnosis and Clinical Treatment of Ovarian Granulosa Cell Tumor

目的探讨卵巢颗粒瘤的影像特征及临床治疗。方法回顾性分析11例病理证实的卵巢颗粒瘤的CT、MRI及临床资料。结果 110例单发,其中左侧7例,右侧3例;1例双侧多发。8例圆形,边界清晰,3例分叶状,边界模糊。7例子宫体积增大,其中4例伴内膜增生。2CT表现:5例不均匀实性肿块,伴小囊状或片状低密度区,分界清晰,1例呈蜂窝状;3例轻度强化,2例中度强化。1例为多房囊性肿块,囊壁和分隔厚薄不均,明显强化。3MRI表现:4例囊实性肿块,呈蜂窝状,囊壁及分隔厚薄不一,明显强化。3例实性肿块,不均匀中度强化,包膜完整。1例囊性肿块,分隔及囊壁明显强化。4随访时间0.5-8年,9例术后至今无复发,其中5年存活者4例;1例I期失访,1例III期术后2年复发。结论卵巢颗粒瘤具有一定的临床及影像学特征,以手术治疗为主,手术范围要结合年龄、生育情况、肿瘤临床分期及细胞组织学分级综合决定。

Objective To investigate the imaging features and clinical treatment of ovarian granulosa cell tumor （OGCT）.Methods CT 、MRI and clinical datas of 11 cases with OGCT proved by pathology were retrospectively analyzed.Results ① 10 cases were single, there were 7 cases at left and 3 cases at right; 1 case was bilateral multiple. 8 cases were round with clear boundaries, 3 cases were lobulated with fuzzy boundaries. 7 cases of uterine increased, including 4 cases with endometrial hyperpla. ② CT manifestations： 5 cases were non-uniform solid masses with small cystic or flake low-density and clear boundaries, 1 case showed honeycomb. 3 cases slightly enhanced, 2 cases moderately enhanced. 1 case was multiple cystic mass, cyst walls and separated were uneven thickness and significantly enhanced. ③ MRI manifestations： 4 cases were cystic and solid masses with honeycomb, cyst wall and separated were uneven thickness and significantly enhanced. 3 cases were solid masses with encapsulated and uneven moderately enhanced. 1 case was cystic masses, cyst wall and separated significantly enhanced. ④ Following-Up from 6 months to 8 years, 9 patients had no recurrence so far, of which 4 patients survived 5 years; 1 case with stage I lost to follow, 1 case of stage III recurrenced after 2 years.Conclusion OGCT had certain clinical and imaging features, operation was its main treatment, and surgical ranging was comprehensive decided due to age, fertility, clinical stage and histological grade.