卵巢子宫内膜样腺纤维瘤1例

A case of ovarian endometrioid adenofibroma

目的探讨卵巢子宫内膜样腺纤维瘤的影像特点,以提高对该疾病的认识。方法回顾性分析1例经病理证实的卵巢子宫内膜样腺纤维瘤的影像表现,并复习相关文献。结果超声检查可见盆腔囊实性肿物,囊性回声内可见分隔,彩色多普勒成像(CDFI)显示实性部分有血流信号。CT可见盆腔内混杂密度肿物,病灶中间密度不均,增强扫描呈不均匀强化,病变两侧密度均匀,增强扫描无强化。MRI可见子宫后壁增厚,可见多发散在小囊状T_(2)WI高信号,两侧附件区可见多发囊实性肿物;囊性部分于T_(1)WI上呈高/稍高信号,T_(2)WI上呈低/高信号,实性部分于T_(1)WI上呈稍低信号,T_(2)WI上呈高信号;增强扫描显示实性部分呈中度不均匀强化,囊性部分无强化,实性部分内见间隔样结构,于T_(1)WI呈低信号,T_(2)WI呈低信号,增强扫描呈渐进样强化。结论卵巢子宫内膜样腺纤维瘤影像表现具有一定的特征,对其充分认识有助于准确诊断。

Objective To investigate the imaging features of endometrioid adenofibroma of the ovary to improve the understanding of this disease.Methods To retrospectively analyse the imaging manifestations of a case of pathologically confirmed endometrioid adenofibroma of the ovary and review the relevant literature.Results Ultrasonography revealed a cystic solid pelvic mass with visible segregation within the cystic echoes,and color doppler flow imaging(CDFI)showed visible blood flow signal in the solid portion.CT shows a mixed density mass in the inner pelvis,with uneven density in the middle of the lesion and inhomogeneous enhancement on enhancement scan,and even density on both sides of the lesion with no enhancement on enhancement scan.MRI showed thickening of the posterior wall of the uterus,with multiple scattered small cystic T_(2)WI high signals,and multiple cystic solid masses were seen in the adnexal region on both sides,The cystic portion showed high/slightly high signal on T_(1)WI and low/high signal on T_(2)WI,while the solid portion showed slightly low signal on T_(1)WI and high signal on T_(2)WI,The enhancement scan showed moderate heterogeneous enhancement in the solid portion and no enhancement in the cystic portion,A septal-like structure is seen within the solid portion,which is low-signal at T_(1)WI and low-signal at T_(2)WI,with progressive enhancement on enhancement scan.Conclusion The imaging presentation of endometrioid adenofibroma of the ovary is characteristic,and its adequate knowledge helps in accurate diagnosis.