卵巢性索间质肿瘤的^18F—FDGPET／CT影像表现与病理对照分析

Relationship of PET/CT characteristic manifestations and pathology in ovarian sex cord-stromal tumor

目的 探讨卵巢性索间质肿瘤（SCST）^18F-FDG PET/CT影像表现,并与其病理特点进行对照分析.方法 回顾性分析2011年11月至2015年12月间沈阳盛京医院经病理证实为SCST的40例患者（中位年龄57岁） ^18F-FDG PET/CT影像学表现;勾画ROI,计算并比较SUVmax,探讨患者影像学特征与病理结构特点的关系.采用两样本t检验及单因素方差分析数据.结果 40例SCST患者中,卵泡膜瘤-纤维瘤组肿瘤27例（卵泡膜细胞瘤20例、纤维瘤7例）,颗粒细胞瘤（GCTO）12例,支持间质细胞瘤1例.实性肿块24例,部分肿块内伴多少不等的囊性低密度区;囊实混合性肿物14例,囊性为主肿块伴不规则形或较厚的实性分隔2例.40例患者中,实性与囊实性肿瘤SUVmax分别为2.94±1.64及3.77±1.40（t=2.325,P〉0.05）.卵泡膜细胞瘤、纤维瘤与GCTO SUVmax分别为3.00±1.42、2.32±1.04和3.68±1.65,差异无统计学意义（F=2.036,P〉0.05）.35例肿瘤的实性部分^18F-FDG轻中度摄取（摄取程度低于或等于肝脏）,SUVmax为2.96±1.25;另5例^18F-FDG摄取不均匀增高,SUVmax为6.31±0.96,分别为实性卵泡膜细胞瘤、囊实混合性GCTO各2例,实性支持间质细胞瘤1例,均由病理证实为恶性或具有恶性潜能.结论 ^18F-FDG PET/CT诊断SCST有一定的特征性,且与其病理结构特点存在一定关联.

Objective To investigate the value of PET/CT in the diagnosis of ovary sex cord-stromal tumor （SCST）, and the correlation of PET/CT findings with pathological features.Methods PET/CT findings of 40 patients （median age 57 years） with ovary SCST confirmed by pathology from November 2011 to December 2015 in Shengjing Hospital were retrospectively analyzed.ROI was drawn and SUVmax was calculated.The correlation of imaging features with pathological structural features was analyzed.Two-sample t test and one-way analysis of variance were used.Results Pathological results showed 27 patients were ovarian thecoma-fibroma group （20 patients with theca cell tumor, 7 patients with fibroma）, 12 patients had granulosa cell tumor and 1 patient had sertoli-leydig cell tumor.Solid mass with or without cystic low-density area was found in 24 patients, 14 cases were cystic-solid tumors, and 2 cases showed cystic mass with irregular and thickened septations.SUVmax between solid and cystic-solid tumors was not significantly different （2.94±1.64 vs 3.77±1.40;t=2.325, P〉0.05）.There was no significant difference of SUVmax among theca cell tumors, fibromas and granulosa cell tumors（3.00±1.42, 2.32±1.04 and 3.68±1.65, respectively;F=2.036, P〉0.05）.Slight or moderate ^18F-FDG uptake in solid component was demonstrated in 35 patients （SUVmax 2.96±1.25）.Other 5 cases with high ^18F-FDG uptake （SUVmax 6.31±0.96） were confirmed malignancy or malignant potential by pathological results, including 2 solid theca cell tumors, 2 cystic-solid granulosa cell tumors and 1 solid sertoli-leydig cell tumor.Conclusion There are some features to diagnose ovary SCST on ^18F-FDG PET/CT imaging, which have some correlation with pathological features.