12例卵巢卵黄囊瘤临床及超声表现分析

摘要

Objective:To explore the clinical and sonographic characteristics of the ovarian yolk sac tumor and to evaluate the value of color Doppler ultrasound in diagnosis of ovarian yolk sac tumor.Methods:The clinical and ultrasonographic manifestations of 12 cases of ovarian yolk sac tumor proved by operation and pathology were retrospectively analyzed.Results:①The age of 12 patients varied from 14 to 44.The main clinical manifestations were abdominal distension,pelvic mass,abdominal pain and so on.The onset time was less than a month in 10 cases.10 patients accepted preoperative examination of serum AFP,the serum AFP were found to be higher than normal.The level of CA125 was higher than normal in 8 cases.All yolk sac tumors were unilateral,among which 7 cases were pure yolk sac tumor,5 cases were ovarian malignant mixed germ cell tumors containing yolk sac component.4 patients were in stage Ⅰ A,5 in stage Ⅰ C,1 in stage Ⅱ C,and 2 in stage ⅢC.②The largest diameter of the tumors varied from 71 ～ 185 mm,in which 4 cases were solid mass,7 cases were cystic and solid mass,1 case was cystic mass.Sonographic images showed the masses with clear and smooth margin.10 of 12 tumors showed oval shape.The color flow signals were rich in tumors by color Doppler flow imaging(CDFI),of which 2 cases even had arteriovenous fistula.7 cases had peritoneal effusion,of which 2 cases had pleural effusion.Conclusions:Ovarian yolk sac tumor mainly occurred in adolescence or gestational age period females,having rapid onset and increased serum AFP levels.The color doppler ultrasound is useful in the diagnosis and differentiation of ovarian yolk sac tumor.%目的:探讨卵巢卵黄囊瘤的临床与超声特点,评价彩色多普勒超声诊断卵巢卵黄囊瘤的临床应用价值.方法:回顾性分析12例经手术病理检查证实为卵巢卵黄囊瘤患者的临床及超声表现.结果:①12例患者年龄14 ～44岁,临床主要表现为中下腹胀、盆腔包块、下腹痛等.病程在1月之内10例.术前10例患者行血清甲胎蛋白(AFP)检测,其水平均高于正常；12例中8例患者血清CA125增高.卵巢卵黄囊瘤均为单发,其中7例为单纯卵巢卵黄囊瘤,5例为含有卵黄囊成分的卵巢恶性混合型生殖细胞肿瘤.FIGO分期:ⅠA期4例,ⅠC期5例,ⅡC期1例,ⅢC期2例.②超声检查见12例患者的肿块最大径线为71～185 mm,其中实性肿块4例,囊实性肿块7例,囊性肿块1例.超声图像显示包块边界清晰,大部分呈椭圆形；实性部分彩色血流信号丰富,其中2例甚至见动静脉瘘；7例含有大量的盆腹腔积液,其中2例伴胸腔积液.结论:卵巢卵黄囊瘤主要发生于青春期及育龄期女性,病程快,伴有血清AFP水平明显增高.彩色多普勒超声检查有助于对本病的诊断和鉴别.