卵巢性索间质肿瘤的MRI表现及其与临床病理的相关性

MRI findings of sex cord-stromal tumor of the ovary and their correlation with clinical pathological features

目的探讨卵巢性索间质肿瘤的MRI诊断价值及其MRI表现与病理结构特点的相关性。方法回顾性分析经手术病理证实的28例卵巢性索间质肿瘤的MRI表现,并结合文献探讨其影像学特征与病理结构特点的相关性。结果本组28例卵巢性索间质肿瘤中纤维-卵泡膜组肿瘤21例,占75%,包括卵泡膜细胞瘤8例、卵泡膜纤维瘤10例,MRI上病变表现为实质性或囊实性肿块,信号特点T1WI以等或稍低信号为主,T2WI以等或稍高信号为主,多伴有囊变、坏死,纤维成分T2WI表现为低信号,增强后实性部分轻-中度强化;纤维瘤3例,病变表现为实质性肿块,T1WI及T2WI均呈低或等信号,常合并出血,增强后轻度强化。颗粒细胞瘤6例,占21.43%,病变常呈多房囊样改变,信号特点T1WI以等或低信号为主,T2WI以高信号为主,增强后病变实性成分明显强化。硬化性间质瘤1例,表现为囊实性肿块,信号特点T1WI等低信号,T2WI等高信号,增强后肿块呈周围强化。结论 MRI可清晰显示肿瘤的大小、形态、内部结构及与周围组织的关系,对卵巢性索间质肿瘤的诊断有一定的特征性,并且每种肿瘤的MRI影像学特征与其病理结构特点存在着一定的内在关联。

Objective To investigate the value of magnetic resonance imaging （MRI） diagnosis for sex cord-stromal tumor of the ovary, and the correlation of its MRI findings with pathological features. Methods The MRI findings of 28 patients of sex cord-stromal tumor confirmed by pathology were retrospectively analyzed. The correlation of imaging features with pathological structural features was analyzed. Results Among the 28 patients of sex cord-stro-mal tumor, 21 （75%） were fibro-theca folliculi tumor, including 8 patents of theca cell tumor, 10 patients of thec-fibro-ma. MRI showed solid or cystic-solid tumor, mainly equal or slightly lower signal on T1WI and equal or slightly higher signal on T2WI. Fiber components showed lower signal on T2WI, with slight uptake on postcontrast enhancement in sol-id component. Three patients were found with fibroma. The tumor exists solid lesion, and appears equal or slightly low-er signal on T1WI and T2WI, often complicated with bleeding. There was slight uptake on postcontrast enhancement in solid component. Six patients （21.43%） were granular cell tumor. The tumor exists multiple cystic lesion, and appears equal or slightly lower signal on T1WI and higher signal on T2WI. There was obvious uptake on postcontrast enhance-ment in solid component. One patient were sclerosing stromal tumor. The tumor was cystic-solid, and appears lower sig-nal on T1WI and higher signal on T2WI. There was obvious uptake on postcontrast enhancement in edge of the mass. Conclusion MRI can clearly show the tumor＆#39;s size, shape, internal structure and the relationship with the surrounding tissues. There are some characteristics to assess and diagnosis gonadal stromal tumors on MRI, and MRI features of each type of tumor have a certain internal correlation with pathological structural features.