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卵巢甲状腺肿的超声及MRI诊断并文献复习

作者:郭云怀 霍 华 冷丽丽 李文娟 王金霞

所属单位:广东省第二人民医院超声科 (广东 广州 510317)

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摘要

目的 分析和总结卵巢甲状腺肿的超声及MRI特征,以便提高该病的诊断正确率。方法 回顾性分析在我院经手术后 病理证实的7例卵巢甲状腺肿的超声及MRI资料,总结其影像学诊断特征并复习相关文献。结果 7例病灶均为单侧, 3例为多房囊性,4例为囊实性,超声及MRI均显示肿块与周围组织分界清,超声显示分隔为厚薄均匀或厚薄不一的 中等或者稍高回声,内壁实性突起部分为中等或高回声,内可见血流信号,2例可见强回声钙化;MRI显示肿块囊性 成分信号复杂,T1WI及T2WI囊液表现为低信号、等信号或者高信号,实性部分T1WI为等信号,T2WI为等信号或者稍 高信号,增强扫描时,液性成分无强化,囊壁、分隔及实性突起部分明显强化,实性成分强化方式与甲状腺组织类 似。结论 卵巢甲状腺肿的超声及MRI表现均具有一定特征性,能为该病的诊断提供有鉴别诊断价值的信息。

Objective The characteristics of ultrasound and MRI of ovarian goiter were analyzed and summarized in order to improve the diagnostic accuracy of the disease. Methods The ultrasound and MRI data of 7 cases of ovarian carcinoma confirmed by pathology after operation in our hospital were analyzed retrospectively. The imaging diagnostic features were summarized retrospectively and the relevant literature was reviewed. Results All lesions were unilateral in 7 cases, 3 cases were multilocular cystic, 4 cases of cystic solid, ultrasound and MRI showed the boundary between the mass and the surrounding tissue. Ultrasound showed a medium or slightly hyperechoic echo separated by a uniform or uneven thickness. The solid protrusions of the inner wall are medium or hyperechoic. Internal visible blood flow signal, strong echo calcification in 2 cases. Complex signal intensity of Cystic components in MRI, the cystic fluid on T1WI and T2WI showed low signal intensity, iso-signal intensity or high signal intensity. The solid part of T1WI is isointense and T2WI is isointense or slightly hyperintense. During enhanced scanning, liquid components were not enhanced, cystic wall, septum and solid protuberance were significantly enhanced, the density of the enhanced solid components is similar to that of thyroid tissue. Conclusion Ultrasonographic and MRI findings of ovarian goiter have some characteristics,It can provide valuable information for the diagnosis of the disease.

【关键词】卵巢甲状腺肿;超声检查;磁共振成像

【中图分类号】R711.75;R445.1;R445.2

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2018.04.014

前言

卵巢甲状腺肿(struma ovarii,SO)是一种来源 于生殖细胞的特殊类型畸胎瘤,占卵巢畸胎瘤的 2.7%[1],因临床表现不典型或者合并多种疾病而导致 诊断不明确。本研究回顾性分析7例经手术及病理证 实的SO的影像学资料,结合相关文献总结其超声表现 及核磁共振(Magnetic resonance imaging,MRI)表 现,以期提高临床及影像学医生对该病的认识,从而 提高该病的术前早期诊断准确率。