卵巢甲状腺肿的MDCT和MRI表现

MDCT and MRI findings of struma ovarii

目的分析卵巢甲状腺肿(struma ovarii,SO)的多排螺旋CT(MDCT)和MRI表现,总结具有诊断价值的征象。方法回顾性分析经手术病理证实的10例SO患者的临床资料及MDCT和MRI表现,其中2例同时行CT和MRI检查,图像分析包括病灶数目、位置、大小、形态、边界、密度、囊实性比例、强化幅度等。结果10例SO均为单发附件区囊实性肿块,9例为多房囊实性肿块,3例伴高密度囊腔,MRI显示大部分囊性成分T1WI为低信号,T2WI为高信号,其中1例含高密度的囊液在T2WI呈极低信号;6例病灶实性为主,平扫肿瘤边缘显示欠清,增强后轮廓清晰伴实性病灶明显强化(CT增强幅度平均87.5HU)。此外,9例伴有盆腔积液;3例伴钙化,表现为实性区及囊壁簇状、蛋壳样钙化;4例合并同侧成熟畸胎瘤。结论SO的MDCT及MRI表现具有一定的特征,当病灶内高密度囊液在T2WI呈极低信号、实性成分明显强化同时合并成熟畸胎瘤时,应考虑到SO可能。

Objective Multi-detectar computer tomography(MDCT)and MRI manifestations of struma ovarii(SO)were analyzed,and diagnostic signs were summarized.Methods Clinical data and MDCT and MRI findings of 10 SO patients confirmed by surgical pathology were retrospectively analyzed,among whom 2 patients were examined by CT and MRI at the same time.Results All the 10 SO cases were solitary cystic solid masses in the accessory area,9 were multi-atrial cystic solid masses,3 were accompanied by high-density cystic cavities.MRI showed that in most of the cystic components T1WI was low signal,and T2WI was high signal;among them,1 was significantly low signal in the cystic fluid with high density.In 6 cases,solid lesions were dominant,and the margins of the tumor were not clear,and the enhanced contour was clear with obvious enhancement of solid lesions(mean CT enhancement amplitude was 87.5 HU).In addition,9 cases were accompanied by pelvic effusion.Three cases were accompanied by calcification,showing solid area,cystic wall cluster and eggshell calcification.Four patients had ipsilateral mature teratomas.Conclusion MDCT and MRI manifestations of SO have certain characteristics,SO possibility should be considered when hyperdensity cyst fluid in the lesion presents low signal and solid components are significantly enhanced in T2WI and accompanied by mature teratoma.