卵巢纤维卵泡膜细胞瘤的影像学表现及误诊分析

Misdiagnosis and imaging features of ovarian fibrothecoma

目的探讨卵巢纤维卵泡膜细胞瘤的影像学表现,并对其误诊原因进行分析。方法回顾性分析我院收治并经病理证实的卵巢纤维卵泡膜细胞瘤16例女性患者的临床及影像学资料,年龄50.5±11.8岁,均行CT或MR检查。由两名放射科医生共同阅读患者CT及MR图像,描述病灶位置、大小、形态、密度、信号、强化表现,并分析该病被误诊的原因。结果 16例卵巢纤维卵泡膜细胞瘤均为单侧发病,平均直径10.9 cm,呈不均匀信号或密度。12例病灶呈实性或以实性为主的囊实性包块,8例病灶实性部分可见T2低信号影,15例行增强扫描的病灶中,13例病灶呈轻中度不均匀强化。出现血清CA125水平增高、雌激素水平增高、盆腔积液的患者分别为9例、2例、2例。16例病灶,被误诊为上皮性肿瘤3例,子宫浆膜下或阔韧带肌瘤3例。结论卵巢纤维卵泡膜细胞瘤的影像学表现具有一定的特征性,但容易被误诊。

Objective To explore the imaging features and reasons of misdiagnosis in ovarian fibrothecoma.Methods The clinical and imaging data of 16 female patients with pathology confirmed ovarian fibrothecoma were analyzed by two radiologists.The patients were conducted of CT or MR imaging examinations.The location,shape,maximum diameter,signal intensity or density,and enhanced pattern of the lesions were depicted.The reasons of misdiagnosis were explored.Results The tumors involved unilateral ovaries in all 16 patients,with the average maximum diameter of 10.9 cm.All the lesions showed the inhomogeneous signal intensity or density.Twelve lesions exhibited solid or solid-predominant mixed mass,and 8 lesions were found hypointensity area of parenchymal part on T2 weighted images.With the injection of contrast to 15 cases,13 lesions presented slightly to moderately enhancement.Increase of serum CA125,estrogen level,and pelvic effusion were found in 9,2 and 2 patients,respectively.Of 16 cases,3 cases were misdiagnosed for epithelial tumors,and 3 cases for subserosal fibroids of uterus or broad ligament fibroids.Conclusion The ovarian fibrothecomas exhibit certain characteristic imaging features,but they are prone to be misdiagnosed.