卵巢卵泡膜纤维瘤组肿瘤MRI表现与病理对照分析

Ovarian Fibrothecomas:MRI findings and clinicalpathology

目的探讨卵巢卵泡膜纤维瘤组肿瘤的MRI表现,并与临床病理对照分析,以提高其认识和诊断。方法回顾性分析23例经手术病理证实的卵巢卵泡膜纤维瘤组肿瘤患者的MRI及临床资料,并复习文献。结果患者平均年龄54.2岁,其中绝经后患者16例。病灶单发21例,其中左侧卵巢13例,右侧卵巢8例,双侧卵巢仅2例。体积较大,肿块平均横截面积约5.8cm×7.6cm。形态不规则,14例呈分叶状。20例病灶边界清晰,3例边界不清。MRI平扫,囊实性肿块19例,实性4例,肿块实性部分T1WI等、稍低信号,T2WI等、低信号,5例稍高信号,DWI呈高、稍高信号。增强后大多轻-中度强化,6例边缘强化较明显,8例见强化的包膜,表现为缓慢延迟性强化特征,囊性部分无明显强化。23例病灶强化程度均低于子宫肌层,可合并子宫肌瘤、子宫内膜增厚、卵巢囊肿等雌激素升高所致异常影像征象。17例伴有盆腔积液。结论卵巢卵泡膜纤维瘤组肿瘤绝经后女性多见,MRI上具有一定的特征性表现,结合相关临床资料,有助于提高其正确诊断,确诊依赖病理。

Objective To explore MRI findings of ovarian fibrothecoma and to compare with the clinicalpathology so as to improve the recognition and diagnosis.Methods The MRI findings and clinical data of 23 cases with histopathologically proved fibrothecoma were analyzed retrospectively,with literature review.Results The patients were female with an average age of 54.2 years old in which 16 cases were postmenopausal.21 cases were single,in which 13 cases were located in the left ovary,8 were right,and only 2 cases were bilateral.The shapes were irregular in which 6 cases were lobulated.The average size of the masses was about 5.8 cm×7.6 cm and 20 cases had clear boundary,3 were vague.The tumors were cystic-solid in 19 cases and solid in 4 cases in which the solid part of the masses showed sightly hypointense to isointense on T1WI,hypointense to isointense on T2WI in which 5 cases were slightly hyperintense,slightly hyperintense/hyperintense on DWI.Most tumors were found mild-moderate enhancement,in which 6cases were more obvious on the edge,8 cases showed enhanced capsule and all showed slow delayed enhancement characteristics,cyst-like regions were not enhanced.The degree of enhancement was lower than the myometrium and ascites was detected in 17 cases.It can be combined with uterine fibroids,endometrial abnormalities,ovarian cysts and other abnormal images caused by estrogen increased.Conclusion Fibrothecoma is more predilection to the postmenopausal female,and has certain characteristics imaging on MRI.Combined with clinical data,it can help to improve the correct diagnosis,the final diagnosis depends on pathology.