MRI对卵巢颗粒细胞瘤的诊断价值及病理对照研究

Value of MRI in the diagnosis of ovarian granulose cell tumor and its pathological comparison

目的分析卵巢颗粒细胞瘤(OGCT)的MRI表现,探讨该病的特征影像学表现。方法回顾性分析经手术及病理证实的20例OGCT患者的MRI表现,并与病理结果进行对照。结果20例OGCT(21个病灶)中,1例(5.0%)为双侧,19例(95.0%)为单侧;病灶长径为3.2~14.7 cm,平均(8.1±3.3)cm;实性8例(38.1%),囊性7例(33.3%),囊实性6例(28.6%);实性肿块长径约(5.8±1.6)cm,小于囊性及囊实性肿块的(9.4±3.4)cm,差异具有统计学意义(P<0.05)。T_(1)加权成像(T_(1)WI)上肿块以稍高信号为主(18例,85.7%),81.0%可见T_(1)高信号出血灶;T_(2)加权成像(T_(2)WI)上肿块以高信号为主(15例,71.4%),90.5%可见“蜂窝征”或“海绵征”。成人型OGCT 19例(95.0%),幼年型OGCT 1例(5.0%)。OGCT MRI表现与大体病理基本符合。结论“蜂窝征”或“海绵征”及出血灶是OGCT的特征性MRI表现,且肿块体积越大,囊性变越明显;掌握OGCT MRI特征表现及病理基础对于该病的术前诊断及鉴别诊断有重要意义。

Objective To analyze the MRI findings of ovarian granulosa cell tumor(OGCT),and to explore the characteristic imaging features of the disease.Methods The MRI findings of 20 patients with OGCT confirmed by surgery and pathology were retrospectively analyzed and compared with the pathological results.Results Among the 20 cases of OGCT(21 lesions),1 case(5.0%)was bilateral lesions and 19 cases(95.0%)were unilateral lesions;the long diameter of the lesions was 3.2-14.7 cm,with an average of(8.1±3.3)cm;8 cases(38.1%)were solid masses,7 cases(33.3%)were cystic masses,and 6 cases(28.6%)were cystic-solid masses;the long diameter of solid masses was about(5.8±1.6)cm,which was smaller than(9.4±3.4)cm of cystic-solid masses,and the difference was statistically significant(P<0.05).The masses of T_(1)weighted imaging(T_(1)WI)were mainly slightly high signal(18 cases,85.7%),and 81.0%showed T_(1)high bleeding signal;the masses of T_(2)weighted imaging(T_(2)WI)were mainly high signal(15 cases,71.4%),and 90.5%showed"honeycomb sign"or"sponge sign".There were 19 cases of adult OGCT(95.0%)and 1 case of juvenile OGCT(5.0%).The MRI findings of OGCT were basically consistent with the gross pathology.Conclusion The"honeycomb sign"or"sponge sign"and bleeding signal are the characteristic MRI findings of OGCT,and the larger the mass volume,the more obvious the cystic change;mastering the MRI features and pathological basis of OGCT is of great significance for the preoperative diagnosis and differential diagnosis of the disease.