卵巢颗粒细胞瘤的MRI表现及与病理对照分析

MRI manifestations of ovarian granulosa cell tumor and comparative analysis with pathology

目的探讨卵巢颗粒细胞瘤MRI特点,以提高其诊断与鉴别诊断能力。方法回顾性分析25例经手术病理证实的卵巢颗粒细胞瘤MRI资料,并与病理结果对照,总结MRI的表现特征及其与病理改变的相关性。结果25例患者中幼年型4例,其中囊性1例,实性1例,囊实性2例;成人型21例,囊性3例,实性4例,囊实性14例,所有肿瘤均包膜完整,呈类卵圆形,8例边缘呈分叶状,所有病灶囊性部分呈稍长T 1、长T 2信号影,实质性部分呈稍长T 1、稍长T 2信号影,分隔及囊壁呈稍低信号影,其中6例行动态增强扫描,实质性部分呈速升-平台曲线,峰值低于邻近子宫肌层,另外13例行多期增强扫描,病灶实质性部分及分隔均呈明显强化,实质部分强化程度低于同层子宫肌层,肿瘤内部小囊腔及囊性部分壁呈“渔网状”或“蜂窝状”强化,13例肿瘤部分囊腔内合并出血信号影,大体病理标本切面与MRI表现相符合,另16例患者内膜增厚,其中5例子宫内膜不典型增生,1例子宫内膜癌,6例合并子宫肌瘤,1例伴有卵巢液性乳头状瘤,3例合并子宫内膜异位囊肿。结论卵巢颗粒细胞瘤的MRI具有一定特征,结合临床相关症状及激素改变,对于该病的术前诊断及鉴别诊断能够提供重要的诊断依据。

Objective To explore the MR imaging features of ovarian granulosa cell tumor to improve its diagnostic ability and differential diagnosis.Methods MRI data of 25 cases of ovarian ovarian granulosa cell tumor confirmed by surgical pathology were analyzed retrospectively and compared with pathological structure to summarize MRI features and correlation with pathological changes.Results Among 25 cases of patients,4 cases were juvenile type,one case was cystic,one case was solid,and two cases were solid;As for 21 cases of adult type,there were 3 cystic cases,4 solid cases and 14 solid cases.All the tumors were completely covered and ovaloid,and the margins were lobulated in 8 cases.The cystic parts of all lesions showed slightly longer T1 weight imaging and longer T2 weight imaging.The substantial parts were slightly longer T1 weight imaging and slightly longer T 2 weight imaging,and the separation and capsule wall were slightly lower T1 and T2 weight imaging.Among them,6 were performed dynamic enhancement scanning,and the substantial part presented a fast-platform curve,and the peak value was lower than the adjacent myometrium.Another 13 underwent multiphase enhancement scan,lesions substantial part and separation were significantly improved,substantial partial reinforcement degree was lower than the peer myometrium,internal vesicle lumen of the tumor and cystic part wall showed"fishing net"or"honeycomb"strengthening,13 cases within the lumen of the tumor part presented with bleeding signal,gross pathologic specimens cut surface was consistent with MRI performance.Another 16 patients had thickened endometrium,including 5 cases of dysplasia of endometrium,1 case of endometrial carcinoma,6 cases of uterine fibroid,1 case with ovarian fluid papilloma,and 3 cases with endometriosis cyst.Conclusion MRI of ovarian granulosa cell tumor has certain features.Combined with clinical symptoms and hormonal changes,it can provide important diagnostic basis for preoperative diagnosis and differential diagnosis of this disease.