卵巢硬化性间质瘤的MRI表现与病理特征分析

MRI Findings and Pathological Characteristics of Ovarian Sclerosing Stromal Tumor

目的探讨卵巢硬化性间质瘤(SST)的MRI表现和病理特征,并分析其影像学特点,以提高MRI对SST的诊断能力。资料与方法回顾性分析经病理证实为SST患者8例,分析其病灶形态、大小、信号及强化模式,并与病理形态学特点进行对比。结果 8例患者病灶均为边缘较清晰的单发囊实性包块,包膜完整。3例囊性者典型征象为"湖岛征",5例实性者中央可见"瘢痕样""星芒状"囊变区,MRI增强扫描病灶实性部分呈"海绵状血管瘤样"渐进性持续性强化,呈"快进慢出"特征,其囊性部分不强化。MRI表现与病灶形态、显微镜下假小叶结构及丰富的小血管等病理特点相符合。结论 SST的MRI表现具有一定的特征性,能较准确地反映其病理特点,有助于与卵巢其他肿瘤的鉴别诊断,为临床手术方式的选择提供客观依据。

Purpose To investigate the MRI findings and pathological characteristics of ovarian sclerosing stromal tumor（SST） and analyze its image features so as to improve MRI diagnostic ability. Materials and Methods The MRI and clinical data of 8 SST cases confirmed by surgery and pathology were studied retrospectively in terms of location, area, shape, size, MRI signal and enhancement property, and were also compared with the pathological findings. Results All the 8 cases were shown with single cystic-solid mass which had clear borderline and amicula. The ＂lake-island＂ sign was showed in 3 cysticbased SST cases, and ＂cicatricle＂ or ＂aristiform＂ signs were manifested in the other 5 solidbased SST cases on T2WI. After contrasted enhancement, the solid parts in the lesions presented the style like that of angioma cavemosum, and the enhancement continued on the delayed phase like ＂fast wash-in and late wash-out＂ mode; but the enhancement was seldom found in cystic part. The MRI manifestations were consistent with the pathological characteristics of the lesions under the optical microscope such as gross morphology, structure of pseudo lobules and rich small blood vessels. Conclusion The MRI manifestations of SST are consistent with its pathological findings, which is therefore helpful in the differential diagnosis with other kinds of ovarian tumors and can provide more objective evidence in the choice of surgery mode.