儿童卵巢幼年型颗粒细胞瘤的CT特征分析

CT characteristics of juvenile granulosa cell tumor of ovary in children

目的:探讨儿童卵巢幼年型颗粒细胞瘤(JGCT)的CT特征,提高对该病的诊断能力。方法:回顾性分析13例经病理证实的儿童卵巢JGCT的临床及术前CT资料,1例仅行CT平扫,12例行CT增强。结果:13例患儿的主要表现为性早熟(8例)、腹痛腹胀(3例)或腹部肿块(2例);术前血清雌二醇升高11例(4例伴总睾酮升高)。CT均表现为边界清楚的单侧(5例左侧,8例右侧)肿块,囊性2例,囊实性10例,实性1例;增强后,实性部分呈中-明显渐进性强化,囊性部分无强化。11例(11/12)见子宫动脉-卵巢支增粗,其中3例伴卵巢动脉或其他血管增粗,5例见卵巢静脉扩张。10例伴子宫增大,2例伴大量腹水,1例伴多发性内生软骨瘤。结论:儿童JGCT的CT表现具有一定特征性,结合性早熟、激素水平等临床资料,有助于提高本病的诊断准确性。

Objective:To investigate the CT features of juvenile granulosa cell tumor(JGCT)of the ovary in children to improve imaging diagnostic performance about the disease.Methods:The clinical and preoperative CT data of 13 cases with pathologically confirmed JGCT were analyzed retrospectively.Among them,one underwent plain CT scan,12 received contrast-enhanced CT scan.Results:Thirteen patients most commonly presented with precocious puberty(8 cases),followed by abdominal distension and pain(3 cases)or an abdominal mass(2 cases).Preoperative serum estradiol increased in 11 children(4 cases combined with elevated total testosterone).On CT images,a well-defined unilateral mass was found in all cases.The imaging features were cystic(n=2),cystic-solid(n=8)and solid(n=1).The solid components demonstrated moderately-obviously progressive enhancement,while the cystic parts showed no enhancement.The ovarian branch of uterine artery was found thickened in 11 patients(11/12),including 3 patients combined with thickened ovarian artery or other arteries.Dilatation of ovarian vein was shown in 5 cases.10 patients were associated with uterine enlargement,2 cases with massive ascites and 1 case with enchondromatosis.Conclusion:The CT findings of JGCT in children have certain characteristics,combined with clinical data such as precocious puberty and elevated hormone levels,which is helpful to improve the diagnostic accuracy of this disease.