卵巢卵泡膜细胞瘤的MRI表现与病理对照

The comparative study of MRI appearances of ovarian thecoma with pathologic findings

目的 :探讨卵巢卵泡膜细胞瘤(OT)的MRI表现与病理基础。方法 :回顾性分析7例经病理证实的OT患者的临床、MRI和病理资料,并分析其MRI表现与病理基础。结果 :7例肿瘤均为单发,呈圆形或卵圆形,均见低信号包膜。T1WI呈等或低信号;T_2WI低信号为主,1例主要表现为云絮状高信号,夹杂低信号;6例病灶内见囊性区,4例包膜下见囊性区,1例肿瘤外上方见多个小囊性灶。增强扫描后7例肿瘤实性部分轻度强化,延迟后呈渐进性强化,但低于子宫肌层。显微镜下瘤细胞比例1例较高,6例较低;纤维成分6例较高,1例较低;可见假包膜及囊变、水肿区。结论:OT在T_2WI的信号特点和轻度渐进性强化方式有一定特征,能反映其病理基础,掌握其MRI表现有助于提高术前诊断准确率。

Objective：To analyze and compare the MR imaging of ovarian thecoma with pathologic findings. Methods：7cases of ovarian thecoma confirmed by histopathology were retrospectively analyzed. The MR imaging characteristics of the tumor were observed and compared with pathological results. Results：All 7 cases of ovarian thecoma were single,solid,and appeared round or oval. A thin T2-hypointense capsule was present in all 7 cases. The majority of the ovarian thecoma were isointense to hypointense compared with uterine myometrium on T1-weighted and T2-weighted images,where 1 case appeared slight hyperintense mainly with irregular hypointense. Central or peripheral degeneration was seen in 6 cases. Peripheral subcapsular high T2 signal cystic areas were present in 4 cases. We also noted several peripheral small,usually subcentimeter,cysts in 1 case. The 7 patients who received IV gadopentetate dimeglumine showed slight enhancement in its solid part at early arterial phase and progressive enhancement at delayed phase which were lower than uterine myometrium. All tumors were pathologically confirmed benign,visible pseudocapsule. Degenerative changes were seen in 6 cases. HE stain showed the higher the proportion of one case of tumor cells,relatively fewer fibrocytes,the lower the proportion of six cases of tumor cells,fibrocytes were relatively more. Conclusion：T2signal features and enhancement mode are the characteristics of OT,can basically reflect the pathological features of the tumor,which is helpful to correct preoperative diagnosis.