卵巢卵泡膜瘤-纤维瘤的CT表现及误诊分析

目的 分析总结卵巢卵泡膜瘤-纤维瘤的CT表现及误诊原因,以提高对该疾病的认识.方法 回顾性分析经手术病理明确诊断的12例卵泡膜瘤-纤维瘤患者的临床资料,分析其CT表现及误诊原因.结果 本组仅1例患者术前诊断与术后病理诊断相符合,其余患者均与术后病理诊断不符,属误诊.CT表现:肿瘤最大直径3.0~13.8 cm,平均6.8 cm.边界清楚.呈圆形或卵圆形11例、分叶状1例.肿瘤密度均匀7例,不均匀5例,其中呈囊实性1例,伴小囊变2例、钙化2例、扭转出血坏死1例.增强后肿瘤实性成分轻度强化10例(CT值升高<20 HU),无强化1例,显著强化1例(静脉期CT值升高69 HU).合并少量腹水7例.结论 典型的卵泡膜瘤-纤维瘤CT表现为盆腔内附件区圆形或卵圆形的实质性肿块,边界清楚光整,可伴囊变及钙化,增强后轻度强化.对该疾病的认识不足、检查定位不准确及部分肿瘤缺乏典型的CT表现是导致误诊的主要原因.

Objective To analyze and summarize the CT findings and causes of misdiagnosis of ovarian thecofibroma in order to improve the understanding of the disease. Methods The clinical data of 12 patients with follicular fibroma were analyzed retrospectively. The CT findings and the cause of misdiagnosis were analyzed. Results In this group,the preoperative diagnosis of one patient was consistent with the postoperative pathological diagnosis. CT findings:The maximum diameter of the tumor was 3.0~13.8cm,with an average of 6.8cm. The boundaries were clear. In 11 cases,it was circular or ovoid. The tumor density was uniform in 7 cases and uneven in 5 cases,including one case with cystic sex,2 cases with small cysts,2 cases with calcification,and 1 case with torsional hemorrhage necrosis. In 10 patients with mild enhancement of the solid components of the enhanced tumor(CT value increased by less than 20HU),one case with no enhancement,and one case with significant enhancement(CT value increased by 69 HU in venous stage). Combined with a small amount of ascites in 7 cases. Conclusions CT of typical follicle-fibroma is a round or ovoid mass in the pelvic region. The boundary is clear and smooth,which can be accompanied by cystic changes and calcification,and is slightly strengthened after enhancement. The main causes of misdiagnosis are the lack of understanding of the disease, inaccuracy in diagnosis and location,and lack of typical CT findings in some tumors.