卵巢甲状腺肿8例CT表现与病理分析

CT Features and Pathological Traits of 8 cases of Struma Ovarii

目的探讨卵巢甲状腺肿的临床、CT特点及诊断价值。方法回顾性分析8例病理证实的卵巢甲状腺肿患者的临床资料及CT表现。结果本组8例患者中位年龄为56岁,3例合并腹水,5例与同侧输卵管或邻近腹膜粘连,CT表现:8例卵巢甲状腺肿病灶均为单发囊性或囊实性肿块,5例伴高密度囊腔。6例行增强扫描,其中4例实性区及囊壁可见中度及明显强化,2例囊壁强化不明显,6例囊腔均无强化。病理示肿瘤实质主要由大小不等、内含胶质的甲状腺滤泡样结构组成,滤泡上皮为单层扁平、立方上皮或柱状上皮,细胞无异形性。8例中伴有成熟畸胎瘤成分5例,单纯型卵巢甲状腺肿2例,内膜样囊肿成分1例。结论卵巢甲状腺肿的CT表现常为边界清的囊性或囊实性肿块、囊壁及实性部分明显强化、可伴高密度囊腔、钙化,能部分反映此瘤的病理特征,对其诊断和鉴别诊断具有重要价值,对于不典型病例仍需依靠病理学检查。

Objective To summarize the clinical,CT features and diagnostic value of struma ovarii(SO).Methods The clinical and CT findings of 8 patients with SO confirmed by pathology were summarized retrospectively.The CT diagnosis,clinical and pathological characteristics of SO were reviewed.Results The median age of 8 patients was 56 years old.3 cases were complicated with ascites,5 lesions was adhesive with the fallopian tube or peritoneum.In CT finding results,all of the 8 cases showed unilateral,cystic or cystic-solid masses with high density cystic fluid.Calcification and adipose were found in 4 and 2 cases separately.6 of 8 patients underwent pre-and post-contrast CT scan.The solid component and the cyst wall in 4 patients presented as moderate to obvious enhancement,while the cystic portions showed no enhancement.The other two patients showed no significant enhancement.Pathological findings showed that the tumor parenchyma was mainly composed of follicular structures of different sizes and containing glia.The follicular epithelium was single flat,cubic or columnar,and the cells were indistinguished-looking.Among the 8 cases,there were mature teratoma components in 5 cases,simple ovarian goiter in 2 cases,and endometrioid cyst components in 1 case.Conclusion struma ovarii has CT features such as cystic or cysticsolid masses with smooth margin,some contains with calcification,ascites,and high density cystic fluid.And marked enhancement in cysticwall and solid part on contrast CT,which can partly reflect the pathological features of the tumor.Pathological examination is still required to diagnose atypical cases.