巨大卵巢卵泡膜细胞瘤与阔韧带子宫肌瘤的MRI鉴别诊断

Magnetic Resonance Imaging for the Differential Diagnosis Between Giant Ovarian Thecoma and Broad Ligament Myoma

目的探讨巨大卵巢卵泡膜细胞瘤和阔韧带子宫肌瘤的MRI鉴别诊断。方法回顾性分析本院2015年2月至2017年12月经病理证实的18例卵巢卵泡膜细胞瘤和27例阔韧带子宫肌瘤患者的MR资料,观察比较两者的MRI表现,并与病理对照。结果 16例巨大卵泡膜细胞瘤在T1WI及T2WI上表现为混杂信号,17例肿瘤实性成分增强扫描呈轻、中度强化,15例(83.3%)可见来自卵巢的供血动脉,所有卵泡膜细胞瘤同侧卵巢均显示不清。所有阔韧带子宫肌瘤在T1WI及T2WI上表现为混杂信号,21例实性成分增强扫描与子宫肌层强化程度相同,22例(81.5%)可见来自子宫的供血动脉,19例(70.4%)同侧卵巢部分可见。结论卵巢卵泡膜细胞瘤与浆膜下子宫肌瘤在MRI平扫上表现相似。MRI增强扫描、检测肿块的供血动脉、仔细评估同侧卵巢和肿瘤之间的关系等有助于两者的鉴别。

Objective To investigate the differential diagnosis of the group of giant ovarian thecoma and broad ligament myoma in MRI.Methods The author(s)retrospectively analyzed eighteen cases of ovarian thecoma and twenty-seven cases of broad ligament myoma confirmed by pathology from February 2015 to December 2017 and compared the pathological findings.And the MRI features of the two tumor groups were observed and compared carefully.Results 16 cases of giant ovarian thecoma exhibited mixed signal on T1 and T2 weighted image.Enhanced MRI showed that 17 cases of ovarian thecoma slight-moderately enhanced.We could visualize the artery from the ovary in 83.3%(15/18)ovarian thecomas.The ipsilateral ovary of all the ovarian thecoma is unclear.All the broad ligament myoma exhibited mixed signal on T1 and T2 weighted image.Enhanced MRI of 21 cases of broad ligament myoma showed evident enhancement.We could visualize the artery from the uterus in 81.5%(22/27)broad ligament myoma.The ipsilateral ovary can be seen in 70.4%(19/27)cases.Conclusion Giant ovarian thecoma and broad ligament myoma appear similar on MR plain scans.On enhanced MR Imaging、detection the tumor’s feeding artery and assessment of the relationship between ovaries and tumors was helpful in the differential diagnosis between broad ligament myoma and ovarian thecoma.