卵泡膜瘤不同病理亚型的CT表现分析

Analysis of CT Findings in the Different Pathological Subtypes of Ovarian Theca Folliculi Tumor

目的分析卵泡膜瘤不同病理亚型的CT表现,提高卵泡膜瘤各亚型不同CT表现的认识,进一步提高卵泡膜瘤的CT诊断准确率。方法回顾性分析经手术及病理证实的45例卵泡膜瘤的CT表现及病理资料,所有病例均行CT平扫及增强扫描。结果 45例中卵泡膜细胞瘤15例,纤维卵泡膜瘤18例,卵泡膜纤维瘤12例;共54个病灶,其中单发40例,多发5例。肿瘤长径为2.2~18.0 cm（平均9.0 cm）,其中卵泡膜细胞瘤、纤维卵泡膜瘤及卵泡膜纤维瘤的平均长径分别为10.0 cm、12.8 cm及5.2 cm,后者与前两者有显著统计学差异。25个病灶呈圆形或类圆形,29个病灶呈分叶状,后者多见于卵泡膜纤维瘤。卵泡膜细胞瘤、纤维卵泡膜瘤及卵泡膜纤维瘤平扫CT均值分别为21 HU、35 HU及48 HU。增强扫描54个病灶均轻度强化,其中52个病灶CT值增幅〈10 HU。39例（86.7%）伴有腹腔积液,23例（51.1%）伴有胸腔积液;34例（75.6%）血清CA125升高,其中12例〉500 U/ml;卵泡膜细胞瘤及纤维卵泡膜瘤患者胸腹腔积液量及CA125水平较高,并且与肿瘤大小呈正相关。结论卵泡膜瘤的大小、形态及密度与病理亚型相关;胸腹腔积液量及血清CA125水平与肿瘤大小呈正相关。

Objective To analyze the CT findings in the different pathological subtypes of ovarian theca folliculi tumor,in order to improve the recognition of different CT findings in various subtypes of theca folliculi tumor. Methods 45 cases of ovarian theca folliculi tumor verified pathologically after surgery were retrospectively analyzed for their CT findings and pathological data. All cases were performed with plain and contrast CT scan. Results There were 15 cases of thecoma,18 cases of fibrothecoma and 12 cases of thecafibroma. There were 54 lesions in 45 cases,including 40 cases of solitary lesions and 5 cases of multiple. The long diameter of all tumors were between 2. 2 ~ 18. 0 cm,and the mean long diameter was 9. 0cm,of which the long diameter of ovarian thecoma,fibrothecoma and thecafibroma was 10. 0 cm,12. 8 cm and 5.2cm respectively. The difference of the latter and the others had statistical significance. The shape of the25 lesions was round or oval,and 29 lesions were lobulated,most of which were seen in the thecafibroma. The mean unenhanced CT value of ovarian thecoma,fibrothecoma and thecafibroma was 21 HU,35 HU and 48 HU respectively. All of 54 lesions were enhanced slighty,of which the increasing CT value range of 52 lesions 〈 10 HU. There were 39 cases（ 86. 7%） accompanied with seroperitoneum,of which 23 cases（ 51. 1%） were accompanied by pleural effusion. Serum CA125 wewas risen in 34cases（ 75. 6%）,of which in 12 cases was 〉 500 U / ml. The ovarian thecoma and fibrothecoma were accompanied with more celom effusion and higher level of serum CA125,which were positively correlated to the tumor size. Conclusion The size,shape and density of theca folliculi tumor were associated with their pathological subtypes. The quantity of celom effusion and the level of serum CA125 were positively correlated to the tumor size.