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卵泡膜-纤维瘤类肿瘤的CT和MRI影像学特征分析

作者:张冰凌

所属单位:河南省新乡市中心医院CT室(河南 新乡 453000)

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摘要

目的分析卵泡膜-纤维瘤类肿 瘤的CT和MRI影像学特征。方法 回顾性 分析我院2015年1月-2017年1月收治的52 例卵泡膜-纤维瘤类肿瘤患者临床资料。 患者接受CT、MRI检查。结果 7.69%绝经 前表现为月经不调、量多,仅有1.92%无 任何临床症状。绝经后患者临床症状表 现多样,无明显规律,但大部分患者均 表现下腹胀痛、不适感。82.69%CA125显 著升高,5.77%未做CA125检测。52例患 者共有61枚肿物,其中单发96.72%,另 3.28%与同侧相连。左侧单发42.62%,右 侧单发54.10%。CT检查共检出54枚病灶, 98.15%病灶密度呈现均匀性,1.85%病灶 为不均匀性。实性部分表现为低信号或等 信号。MRI检出60枚病灶,其中36.67%为 卵泡膜纤维瘤,63.33%为纤维卵泡膜瘤, T2WI显示肿物边缘模糊,有不均匀云雾状 高信号。间质水肿组织表现为高信号,部 分肿瘤内囊变出现高信号,征象为“山间 云雾”。结论 卵泡膜-纤维瘤CT主要特征 为低信号、低密度、类圆形。MRI影像特 征为T1WI高信号、T2WI低信号、“山间云 雾”征。

Objective To investigate CT and MRI features of ovarian theca-fibroma. Methods The clinical data of 52 cases of ovarian theca-fibroma treated in our hospital from January 2015 to January 2017 were analyzed retrospectively. All patients underwent CT and MRI examinations. Results Premenopausal symptoms of 7.69% were irregular menstruation with high volume. Only 1.92% did not have any clinical symptoms. The clinical postmenopausal symptoms were various without settled regularities, while most people had abdominal pain and discomfort. 82.69% of patients had elevated CA125, while the patients without CA125 detection accounted for 5.77%. There were 61 tumors in 52 patients, of which 96.72% were single, and the other 3.28% were connected to the same side. The lesions on the left side accounted for 42.62%, and the right side accounted for 54.10%. The average diameter of ovarian thecoma and ovarian fibrothecoma was (10.59±1.58)cm and (5.69±1.59)cm, respectively. A total of 54 lesions were detected by CT with 98.15% of homogeneous focus and 1.85% of heterogeneous focus. The solid part showed low signal or equal signal, while the rest of the tumor images showed uneven signal with different degrees of cystic degeneration. A total of 60 lesions were detected by MRI including 36.67% of ovarian thecoma and 63.33% of ovarian fibrothecoma. T2WI showed that the edges of the tumor were blurred with an uneven cloud-like high signal. 51.67% of ovarian fibrothecoma had homogeneous signal on T1WI, of which 711.67% had patchy hypointensity. T2WI below the mass was a low signal. The lesions in the arterial phase were not obviously enhanced. The lesions in the venous phase were irregular stripe, no enhancement in the cystic area was found after further enhanced in the parenchymal phase, but a uniform thin film was seen. The high signal was found in the interstitial edema and tumor internal capsule with "mountain clouds" signs. Conclusion Accurate analysis of CT and MRI imaging features can significantly improve the detection rate of ovarian theca-fibroma, and the CT image is characterized by low signal, low density and round like shape, while the MRI features are high signal on T1WI and low signal on T2WI with "mountain clouds" signs.

【关键词】卵泡膜-纤维瘤类肿瘤;CT; MRI;特征

【中图分类号】R737.31;R445.2;R445.3

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2018.11.033

前言

卵泡膜-纤维瘤类肿瘤是临床常见良性肿瘤,患者易合并腹盆腔、 胸腔积液,且CA125生化指标升高,容易误诊为卵巢癌[1]。卵泡膜-纤 维瘤类肿瘤包括卵泡膜细胞瘤、纤维卵泡膜瘤、卵泡纤维瘤,且各种 影像学表现不同[2],极易误诊与漏诊。临床常用各种影像学检查卵泡 膜-纤维瘤类肿瘤[3],其中CT与MRI最常见。本文回顾性分析我院2015 年1月-2017年1月收治的卵泡膜-纤维瘤类肿瘤患者的CT、MRI影像学图 像,总结其特征,现将研究结果汇报如下。