彩色多普勒超声对卵巢颗粒细胞瘤的诊断价值

The value of color Doppler ultrasound in diagnosis and differential diagnosis of ovarian granuiosa cell tumor

目的探讨卵巢颗粒细胞瘤（ovarian granulosa cell tumor，OGCT）的彩色多普勒超声诊断价值。 方法选取手术病理证实为卵巢颗粒细胞瘤患者14例，所有患者术前均行彩色多普勒超声检查，根据OGCT的病理特征将肿物声像表现进行分型，分为实性、囊实混合性和囊性，并应用彩色多普勒血流显像（CDFI）观察病灶的血流信号分布情况，并根据Adler分级标准，将血流信号丰富程度分为0～3级，将超声检查结果与术后病理诊断进行对照分析。 结果本组14例OGCT肿瘤声像表现多种多样，病变可分为囊性（2例）、实性（5例）和囊实混合性（7例），7例囊实混合性OGCT内为含多发小囊性变区域的实性包块；各类型声像肿瘤平均径线间比较，差异有统计学意义（P＝0.0006），肿瘤囊性变越明显，肿瘤平均径线越大；肿瘤内部Adler血流0级4例，1级5例，2级3例，3级2例，不同声像类型的OGCT血流分布间比较差异无统计学意义（P＝0.056）。卵巢颗粒细胞瘤的超声定位诊断符合率为71.4%（10/14），超声定性诊断准确率为35.7%（5/14）。 结论彩色多普勒超声可作为卵巢颗粒细胞瘤首选的术前影像学检查及术后长期随诊的手段，可为临床治疗及评估预后提供更多的诊断信息和依据。

ObjectiveTo discuss the value of color Doppler ultrasound in the diagnosis and differential diagnosis of ovarian granulosa cell tumor （OGCT）. MethodsFourteen cases were diagnosed as OGCT by pathology postoperatively had been examined by color Doppler ultrasound check-up before the surgery. In image appearance, the tumors were divided into cystic mass, solid mass or mixed cystic-solid mass respectively according to their own pathological features. Additionally, the blood flowing signal of OGCT was labeled from 0 to 3 grade with Adler standard based on the blood flowing imaging observed by color Doppler flow imaging（CDFI）. The CDFI results were compared with the pathological diagnosis. ResultsUltrasound image appearance of OGCT varied in the 14 cases.Two of them could be characterized as cystic mass, 5 solid mass and 7 mixed cystic-solid mass. The mixed cystic-solid OGCT contained solid mass in multiple cystic degeneration area. There was a significant difference in the diameter among three kinds of OGCT （P=0.0006）. The more visible cystic lesion indicated the longer diameter of OGCT. According to the CDFI, 4, 5, 3 and 2 cases were 0, 1, 2, 3 grade respectively in Adler standard. No significant difference was found among the four standards groups （P=0.056）. The localization diagnosis accordance rate of the Doppler imaging in OGCT was 71.4% （10/14） and the qualitative diagnosis accordance rate was 35.7% （5/14）. ConclusionsThe color Doppler ultrasonography can be the first-line preoperative imaging investigation in the diagnosis and differential diagnosis of OGCT, as well as in the long-term following after surgery. It can provide more details and evidences for the treatment and prognosis assessment of OGCT.