摘要
目的 观察8例卵巢透明细胞癌患 者CT影像学表现特点,并探讨CT在卵巢透 明细胞癌患者中的诊断价值。方法 回顾 性分析2009年2月-2015年1月我院肿瘤外 科收治经手术病理证实的8例卵巢透明细 胞癌患者的临床资料,所有病例患者均行 CT影像学检查,对所有病例患者CT影像学 临床资料进行分析,以评估CT在卵巢透明 细胞癌患者中的诊断价值。结果 8例病例 患者中,3例左侧发生,5例右侧发生;临 床病理分期Ⅰ期、Ⅱ期、Ⅲ期例数分别为 5例、2例、1例;8例患者均表现为以囊性 成分为主的肿块,左侧3各,右侧5各,直 径7-11cm,瘤体以圆形或椭圆形为主,边 缘光滑,境界清晰,且无钙化情况,其中 单房6例,多房2例,囊液密度均匀,囊性 部分的最低CT值15-30HU;CT增强扫描显 示,囊性成分未见明确强化,边界显示清 晰;病例患者病理表现:肿瘤切面多呈囊 实性,以囊性为主,坏死5例,出血2例, 浆液成分1例,实性切面以鱼肉样或淡黄 色为主要表现。结论 CT影像检查对卵巢 透明细胞癌具有一定特征性,对其具有一 定诊断价值,但缺乏特异性,临床确诊过 程中仍需借助于组织病理学检查。
Objective to observe the 8 cases of ovarian clear cell carcinoma patients with CT characteristic imaging findings, and to explore diagnostic value of CT in ovarian clear cell carcinoma patients. Methods A retrospective analysis in February 2009, in January 2015, our hospital surgical oncology were confirmed by surgical pathology of the clinical data of 8 cases of ovarian clear cell carcinoma, all cases of patients were performed CT imaging examination, CT imaging in patients with all cases clinical data were analyzed, and to assess the diagnostic value of CT in ovarian clear cell carcinoma patients. Results 8 cases patients, 3 cases on the left, 5 cases of right. Clinical pathologic stage Ⅰ stage, Ⅱ, Ⅲ cases respectively in 5 cases, 2 cases, 1 case. 8 patients were predominantly cystic component lump, the left 3 each, on the right side of the 5, 7, 11 cm in diameter, tumors is given priority to with round or oval, edge is smooth, clear, and without calcification, among them 6 cases, single room room in 2 cases, more uniform fluid density, cystic part of minimum 15-30 hu CT value. CT enhanced scan showed cystic components did not see the clear reinforcement, border shows clear; Cases of patients with pathological manifestations: how saccate or solid neoplasm, predominantly cystic, necrosis in 5 cases, hemorrhage in 2 cases, composition of slurry in 1 case, solid edge fish specimens or pale yellow as the main performance. Conclusion CT imaging of ovarian clear cell carcinoma has a certain characteristic, has certain diagnostic value to its, but the lack of specificity, still need to be in the process of clinical diagnosis by histopathological examination.
【关键词】卵巢透明细胞癌;CT;影像学
【中图分类号】R737.31
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.08.032
前言
卵巢透明细胞癌为临床较为少见的卵巢肿瘤,其发病机制尚不明 确,多认为与苗勒氏管有关[1],其发病率在卵巢上皮性恶性肿瘤中所 占比例不高,但恶性程度较高,亦是卵巢上皮性肿瘤预后最差的亚 型,以腹胀、腹部包块、阴道流血或排液为主要临床表现,晚期常合 并有腹水,多数卵巢透明细胞癌可在早期发现,但其各期总生存率较 其他上皮性卵巢癌差,可能与其对化疗药物反应敏感性差有关,对女 性身心健康造成严重威胁,临床对其诊治刻不容缓[2];由于卵巢透明 细胞癌具有较高恶性程度,较低生存率,因而术前正确诊断及分期对 疾病治疗有着重大意义[3],但卵巢透明细胞癌由于其临床表现及实验 室检查无明显典型性,加之超声声像图也缺乏特征性表现,因而对其 诊断存在一定困难,影像学诊断易与其它原发上皮性肿瘤相混淆,该 病行CT扫描时具有部分典型特征[4],为此回顾性分析2009年2月~2015 年1月我院肿瘤外科收治经手术病理证实的8例卵巢透明细胞癌患者的 临床资料,以提高卵巢透明细胞癌诊断水平。
中国CT和MRI杂志
第15卷, 第 8 期
2017年08月
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