卵泡膜细胞瘤-纤维瘤组肿瘤超声造影特征

Contrast enhanced ultrasonographic characteristics of ovarian thecomas-fibromas group

目的观察卵泡膜细胞瘤-纤维瘤组(OTFG)肿瘤的CEUS特征。方法回顾性分析11例经手术和病理证实的OTFG患者(OTFG组)和同期手术的15例附件区恶性实性肿瘤患者(恶性组)CEUS资料。结果 OTFG组中,卵泡膜细胞瘤6例、卵泡膜细胞纤维瘤2例、纤维瘤3例,肿瘤最大径(4.12±1.32)cm,术前CEUS诊断准确率为63.64%(7/11)。CEUS表现:OTFG组肿瘤多呈规则(10/11,90.91%)、有包膜(10/11,90.91%)、内部有造影剂灌注(10/11,90.91%)的实性肿块,OTFG组造影剂开始灌注时间及达峰时间均晚于恶性组[(3.55±0.93)s vs(1.31±1.55)s、(13.91±1.97)s vs(9.31±1.97)s,P均<0.05]。OTFG组造影剂灌注强度以稀疏、弱灌注为主(9/11,81.82%),多呈周边向中央灌注(10/11,90.91%),而恶性组造影剂灌注增强快而强(13/15,86.67%),多呈中央向周边灌注(13/15,86.67%);二者差异有统计学意义(P均<0.05)。三维能量多普勒CEUS血管分型显示,OTFG组与恶性组比较肿瘤内部血管分支少、走形较平直(P<0.05)。结论 OTFG肿瘤CEUS具有一定特征,符合良性肿瘤表现。

Objective To observe the CEUS features of the ovarian thecomas-fibromas group（OTFG）.Methods The contrast enhanced ultrasonographic images in 11 patients with OTFG（OTFG group）and 15 patients with adnexal malignant solid masses（malignant tumor group）proved by operation and pathology were analyzed retrospectively.Results In OTFG group,there were 6cases of the ovarian thecomas,2cases of fibroms and 3cases of thecofibroma,with the largest diameter of（4.12±1.32）cm.The diagnostic accuracy rate of preoperative CEUS was 63.64%（7/11）.Most of tumors in OTFG group were regular（10/11,90.91%）,with capsule（10/11,90.91%）and perfusion（10/11,90.91%）.The initiation time and the peak time in OTFG group were shorter than that in malignant tumor group（[3.55±0.93]s vs[1.31±1.55]s,[13.91±1.97]s vs[9.31±1.97]s,both P〈0.05）.The enhanced intensity was weakly inhomogeneous（9/11,81.82%）and the perfusion pattern mostly display around to central form（10/11,90.91%）in OTFG group,but in malignant tumor group the enhanced intensity was strongly homogeneous（13/15,86.67%）and mostly display from central to around（13/15,86.67%）,there were statistical significations between the two groups（all P〈0.05）.In three diamentional power Doppler angiography imaging,the tumors showed less angiogenesis and the vascular morphology was more straightness in OTFG group compared with malignant tumor group（P〈0.05）.Conclusion The CEUS images of OTFG has certain characteristics of benign tumor,which is helpful for the differential diagnosis from malignant tumors.