卵巢卵泡膜细胞瘤的CT影像诊断分析与病理对照

CT imaging diagnosis and pathological comparison of ovarian follicular cell tumor

目的:探讨卵巢卵泡膜细胞瘤(Ovarian Fibrothecoma,OT)的CT影像表现,并与其病理特点进行对照分析。方法:回顾性分析2014年7月至2017年12月我院经手术病理证实为OT的12例患者的CT图像资料,检查方法包括CT平扫及多期增强扫描,并与其病理特点进行对照分析。结果:12例肿瘤均为单发,边界清楚,圆形或卵圆形10例,轻度分叶状2例,肿瘤最大径范围为11~12cm,平均直径8cm;7例为密度均匀实性肿块,4例为以实性为主的肿块,内伴灶状、裂隙状和片状坏死,1例为囊实性;增强扫描11例病变实性部分轻度延时强化或不强化,CT值增加10~20HU,1例囊实性肿块者实性部分明显强化,CT值增加90HU。影像表现多呈实性伴部分囊性变,与镜下以较多短梭形细胞为主,细胞束交叉排列呈编织状或旋涡状,间质部分区域成纤维细胞增生,部分区域疏松水肿,部分区域玻璃样变等病理特点相一致。结论:卵巢卵泡膜细胞瘤CT表现具有一定的特征性,且与其病理特点存在一定的关联,结合患者的临床表现,有助于提高本病的影像诊断准确率。

Objective To investigate the CT findings of ovarian follicular cell tumor(Ovarian Fibrothecoma,OT)and compare it with pathological features.Methods CT images of 12 patients with OT confirmed by surgery and pathology from July 2014 to December 2017 were retrospectively analyzed.The examination methods included CT plain scan and multiphase enhanced scan,and compared with pathological features.Results 12 cases of tumors were single,with clear borders,10 cases of round or oval,2 cases of mild lobulation,the largest diameter range of tumors was 11-12 cm,the average diameter was 8 cm;7 cases were uniform density solid masses.4 cases were solid-based masses with focal,fissure-like and flaky necrosis,1 case was cystic;11 cases with enhanced scanning were mildly delayed or not enhanced in solid part,CT value Increased 10-20 HU,1 solid cystic mass was significantly enhanced,CT value increased by 90 HU.The image showed more solidity with partial cystic changes,and most of the short spindle cells were observed under the microscope.The cell bundles were arranged in a braided or spiral shape,and the interstitial part of the fibroblasts proliferated,and some areas were loose and edematous.The pathological features such as glassy changes in some areas are consistent.Conclusion The CT findings of ovarian follicular cell tumor have certain characteristics,and there is a certain correlation with its pathological features.Combined with the clinical manifestations of patients,it can improve the accuracy of imaging diagnosis of this disease.