卵巢支持-间质细胞瘤的MRI表现及与病理对照

MRI Findings and Pathological Correlation of Ovarian Sertoli-Leydig Cell Tumors

目的:探讨卵巢支持-间质细胞肿瘤(SLCT)的MRI表现,提高对此病的认识及诊断水平。方法:回顾性分析经手术及病理证实的8例卵巢SLCT的临床及MRI资料,观察肿瘤的部位、大小、形态、边界、囊实性、信号强度、强化程度、实性成分ADC值及伴发腹水、腹膜种植、淋巴转移等特征。结果:MRI上,8例患者共9个肿瘤(中分化7个,中低分化2个),1例患者术后半年对侧卵巢复发。肿块最大径4.4~21.7cm,平均11.2±6.8 cm。5个瘤呈囊性为主型,其中囊液呈均匀水样信号3个,信号不均匀2个;实性成分表现为囊壁及分隔的增厚或沿其生长的宽基底实质区瘤。另4个瘤呈实性,实性区在T2WI上呈低、等或稍高信号,其中2个瘤伴囊变。增强后实性成分明显强化8个,中度强化1个。DWI上,7例8个肿瘤实性成分均表现为DWI高信号、ADC图低信号;6个可测量肿瘤的实性成分平均ADC值为(1.028±0.273)×10^(-3) mm^2/s(0.717~1.381×10^(-3) mm^2/s),中低分化瘤的平均ADC值显著低于中分化瘤[(0.723±0.008)vs(1.181±0.176)×10^(-3) mm^2/s,P=0.025]。结论:MRI可显示卵巢支持-间质细胞肿瘤的形态学特征,结合DWI有助于判断其性质。

Purpose：To investigate the magnetic resonance imaging（MRI） features of ovarian Sertoli-Leydig cell tumors（SLCTs） to improve the understanding and diagnostic accuracy of this tumor. Methods： The clinical and MRI data of 8 patients with SLCTs confirmed by surgery and pathology results were analyzed retrospectively. MRI features of the tumors,including the location,shape,size,boundary,cystic-solid parts,signal intensity,enhancement,ADC value of the solid portion,ascites,peritoneal seeding and lymph nodes involvement,were evaluated. Results： Nine tumors were shown on MRI in 8 patients. One patient was with recurred tumor on the contralateral ovary six months later. The maximum diameter of the tumors ranged from 4.4 cm to 21.7 cm,with the mean diameter of 11.2 ± 6.8 cm. Five tumors were shown as mainly cystic lesions with homogeneous signal in 3 and heterogeneous signal in 2 masses. The solid component of the tumors manifested with a thickened wall/septa or a broad base. Four tumors were shown as a solid mass with hypo-,iso-,or slightly hyper-intensity on T2 WI,and 2 of them were with cystic degeneration. Eight tumors were markedly enhanced and one tumor was moderately enhanced in the solid component of tumors. Eight tumors in 7 patients were shown with hyper-intensity signal on DWI and hypo-intensity signal on ADC map. The mean ADCvalue of six measurable masses was（1.028±0.273）×10^-3 mm^-2/s,of two moderately to poorly differentiated SLCTs was（0.723±0.008）×10^-3 mm^-2/s,and of four moderately differentiated SLCTs was（1.181±0.176）×10^-3 mm^-2/s（P=0.025）. Conclusion： MRI can display the morphological features of SLCT,which was helpful for evaluating the degree of differentiation when combining with DWI.