卵巢卵泡膜纤维瘤的CT表现

CT Findings of Ovarian Thecoma-fibroma

目的:探讨卵巢卵泡膜纤维瘤的CT表现,提高术前诊断水平。方法:回顾性分析18例经手术病理证实为卵巢卵泡膜纤维瘤的临床资料、CT表现与病理特征。结果:18例患者共计18个病灶,均为单侧,10例位于左侧,8例位于右侧。肿瘤最大径范围从1.5~18 cm,平均8.7 cm。13例腹腔见积液,其中4例同时合并有胸腔积液。18个病灶多数呈类圆形或椭圆形,1例伴有浅分叶,4例形态不规则,边界或大部分边界清晰和光整。肿瘤呈较均匀实性密度7例;囊实性密度11例。增强后囊性部分三期均未出现强化;实性肿块或囊实性肿块实性部分增强后动脉期强化不明显,静脉期及延迟期呈持续或渐近性轻度强化,增强后延迟期与平扫比较实性部分CT值增加幅度为2~18 HU,未超过20 HU。结论:卵巢卵泡膜纤维瘤CT特征性表现为单侧边界清晰的实性或囊实性肿块,增强后轻度强化,有时伴有腹水。

Objective: To investigate characteristic CT manifestations of the ovarian thecoma-fibroma and improve the level of preoperative diagnosis. Methods: Clinical data, CT manifestations and pathological features of 18 cases of ovarian thecoma-fibroma were analyzed retrospectively, and the diagnoses were confirmed by pathology after surgery. Results: Our findings included: 18 patients were all unilateral;10 lesions were located in the left side of ovary, while 8 lesions were in the right side. Of the 18 lesions, the largest diameters of tumor ranged from 1.5 to 18 mm with the mean value of 8.7 mm. 13 patients were accompanied by ascites, of which 4 cases were combined with pleural effusion. The shape of 13 lesions appeared round or elliptic, and 1 lesion with lobulation, 4 lesions were irregular. All the tumors had well-defined or mostly well-defined borders. The tumors showed solid density in 7 cases, cystic solid density was observed in 11 cases. No enhancement was found in the cystic part after enhancement. The solid part of solid mass or cystic solid mass showed no obvious enhancement in the arterial phase after injection of the contrast medium, while in venous phase and delayed phase presented continuous and asymptotic slight enhancement. The CT value of the solid part increased by 2~18 HU in the delayed phase after enhancement compared with plain CT scan, and did not exceed 20 HU. Conclusions: The characteristic CT manifestations of the ovarian thecoma-fibroma were often unilateral solid mass with the shape of oval and well defined border;slight enhancement;accompanied by ascites.