卵巢颗粒细胞瘤的影像学表现

Imaging manifestation of ovarian granulosa cell tumor

目的探讨卵巢颗粒细胞瘤(OGCT)的影像学特征,旨在提高术前诊断率,降低误诊率。方法回顾性分析经病理证实为OGCT的26例患者的病例资料,探讨其临床表现、影像学特征。结果26例患者均为单发病变,囊性病变1例,呈多房囊性改变,囊壁光滑,增强扫描囊壁强化。囊实性病变22例,大部分实性病变内可见多发囊变,典型者呈“卵石征”,增强扫描实性成分呈明显强化。实性病变3例,均可见小囊变,增强扫描中度强化。实性成分T1WI呈等、稍高信号,T2WI呈稍高信号,囊性成分T_(1)WI呈低信号,T_(2)WI呈高信号;CT上实性成分呈等密度,囊性成分呈低密度。结论OGCT常呈单发病灶,可表现为以囊性、囊实性、实性为主的肿块,其中囊实性肿块最常见,“卵石征”为其典型表现,因此,了解OGCT的典型影像学表现并结合临床症状和实验室检查有助于诊断,但实性成分肿块诊断仍较困难,最终确诊仍有赖于病理学检查。

Objective To investigate the imaging manifestation of ovarian granulosa cell tumor(OGCT)in order to improve the preoperative diagnosis rate and reduce the misdiagnosis rate.Methods The case data of 26 patients with pathologically confirmed OGCT were retrospectively analyzed,and the clinical manifestations and imaging features were explored.Results All the 26 patients were single lesions,and 1 patient had cystic lesions,showing multilocular cystic changes.The cystic wall was smooth,and the cystic wall was enhanced by enhanced scanning.Cystic-solid lesions were observed in 22 cases.Multiple cystic lesions were observed in most of the solid lesions,the typical ones showed"pebble sign",and the solid components of enhanced scan showed obvious enhancement.Solid lesions were found in 3 cases,all had small cystic lesions,and the enhanced scan showed obvious enhancement.Solid components showed isointense and slightly hyperintense on T_(1)WI,slightly hyperintense on T2WI,cystic components showed hypointense on T1WI and hyperintense on T_(2)WI;On CT,the solid component showed equal density,and the cystic component showed low density.Conclusion OGCT is often single lesions,which can be manifested as the lump mainly cystic,cystic solid and solid.Among them,cystic solid mass is the most common and its typical manifestation is"pebble sign".Therefore,understanding the typical imaging findings of OGCT and combined with clinical symptoms and laboratory examination,is helpful for diagnosis.However,the diagnosis of solid mass is still difficult,and the final diagnosis still depends on pathological examination.