彩色多普勒超声对卵巢性索间质肿瘤的诊断价值

Diagnosis value of color Doppler ultrasound in patients with sex cord-stromal tumor of the ovary

目的观察卵巢性索间质肿瘤的相关病理特征,并探讨彩色多普勒超声对其的诊断价值。方法回顾性分析2007-2019年期间海南医学院第一附属医院经手术病理证实的50例卵巢性索间质肿瘤的超声表现,观察其彩色多普勒超声表现与病理结构特点的相关性。结果 50例卵巢性索间质肿瘤患者共52个病灶,超声声像图特点与病理结果所示瘤体内结构一致。其中纤维卵泡膜瘤30例,超声表现肿瘤呈实性或以实性回声为主,伴后方回声衰减,呈栅栏状或弧形衰减,部分肿瘤内可见条状影,瘤体血供稀少,阻力指数(Resistance Index, RI) 0.5~0.7,超声诊断符合率100%(30/30)。颗粒细胞瘤17例,超声表现以实性或囊实性为主,部分实性成分内见小片状无回声区,7例血供丰富,RI>0.5者12例,RI<0.5者5例,超声诊断符合率为94%(16/17)。硬化性间质瘤3例,超声表现肿瘤以实性为主,内见小片状液性区,瘤体血供丰富,RI 0.25~0.4,超声诊断符合率为100%(3/3);两性母细胞瘤2例,超声表现囊性为主的混合性包块,内见大片状液性区,部分区域成蜂窝状,血供稀少,超声诊断符合率100%(2/2)。结论彩色多普勒超声能清晰显示卵巢性索间质肿瘤的内部结构特点,其声像图表现在一定程度上反映其病理类型。

Objective To observe the related pathological characteristics of ovarian sex cord-stromal tumors,and explore the diagnostic value of color Doppler ultrasound. Methods The performance of color Doppler ultrasound in diagnosis of 50 cases of ovarian cord stromal tumors, confirmed by surgical pathology in the First Affiliated Hospital of Hainan Medical College from 2007 to 2019, was retrospectively analyzed. The correlation of the performance of color Doppler ultrasound and pathological features was observed. Results There were 52 lesions in 50 patients with ovarian sex cord-stromal tumors. The characteristics of ultrasound sonography were consistent with the tumor structure shown by pathological results. Among the 52 lesions, there were 30 cases of fibroblastoma, and ultrasound showed that the tumor was solid or dominated by solid echoes, with attenuation of posterior echoes, showing a fence or arc attenuation.Stripes were visible inside some tumors, and the blood supply to the tumor was scarce. Resistance index(RI) was between 0.5 and 0.7, and the accuracy of ultrasound diagnosis was 100%(30/30). There were 17 cases of granulosa cell tumor, and the ultrasound manifestations were mainly solid or cystic solid, with small patches of echogenic areas seen in some solid components, among which there were 7 cases of vabundant vascularity inside of the tumor, 12 cases of RI>0.5, and 5 cases of RI<0.5;the accuracy of ultrasound diagnosis was 94%(16/17). There were 3 cases of sclerosing stromal tumor. Ultrasound showed that they were mainly solid with small pieces of hypoechoic and the vascularity were usually abundant inside, with RI between 0.25 and 0.4 and the accuracy of ultrasound diagnosis of 100%(3/3). There were 2 cases of amphotomyoma. Ultrasound showed mixed mass mainly with cystic and big pieces of liquid zone, and partly honeycomb. Sparse vascular signals were detected in the tumor. Conclusion Ultrasound can clearly show the tumor’s size, shape, internal structure, and the relationship with the surrounding tissues. The performance of color Doppler ultrasound of each type of tumor has a certain internal correlation with pathological structural features.